COLUMBIA  UBRARIES  OFFSITE 

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HX64096688 
R151  .M91  A  narrative  of  medic 


RRATIVE 

EDICINE 

N    AMERICA 

V  JAMES  GREGORY  MIMFORD.M.D. 


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A  NARRATIVE  OF  MEDICINE 
IN  AMERICA 


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in  2010  with  funding  from 

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A  NARRATIVE  OF 

MEDICINE 

IN    AMERICA 


BY 

JAMES   GREGORY  MUMFORD,  M.D. 

ASSISTANT   VISITING    SURGEON    TO    THE    MASSACHUSETTS 

GENERAL    HOSPITAL    AND     INSTRUCTOR    IN    SURGERY    IN 

THE    HARVARD    MEDICAL    SCHOOL 


PHILADELPHIA    AND    LONDON 

J.    B.    LIPPINCOTT     CO  MPANY 

1903 


Copyright,  1903 

BY 
J.    G.    MUMFORD 

Published  August,  1903 


PmuTtO    BY    J.   B.   LIPPINCOTT    COMPANY,   PMILADtLPHI*,    U.I. A. 


TO 

WILLIAM   OSLER 

THIS    BOOK    IS    CORDIALLY    INSCRIBED    BY 
THE   WRITER 


PREFATORY   NOTE. 


This  book  is  not  a  systematic  history ;  it  is  a  narrative 
of  medicine  and  doctors.  My  object  has  been  to  take  some 
of  the  conspicuous  American  physicians  of  each  era  in 
their  proper  sequence,  to  tell  the  story  of  their  lives  and 
their  doings,  and  thus  to  illustrate  the  whole  by  a  series 
of  pictures,  as  it  were. 

Very  many  men,  dear  to  Dryasdust  and  others,  are 
unnamed ;  very  many  events  are  unchronicled ;  but  I  hope 
the  story  will  show  to  laymen  as  well  as  to  physicians 
something  of  the  meaning  of  medicine  and  of  the  life  of 
its  votaries. 

It  has  always  seemed  to  me  that  of  such  meaning  popu- 
lar conception  was  of  the  dimmest.  The  lawyers  have 
their  great  names  well  known  to  all  readers  of  history; 
the  famous  clergy  of  the  past  are  household  possessions; 
great  statesmen,  insignificant  monarchs,  gallant  soldiers 
and  sailors,  and  even  traitors,  scoundrels,  and  fools,  are 
immortalized  by  writers;  but  of  the  doctors,  few  know 
or  seem  to  care.  Even  their  professional  offspring  neglect 
them,  and  will  tell  you  that  it  is  only  the  science  of  to-day 
which  really  counts;  as  though  we  could  divorce  our- 
selves from  the  past,  as  though  we  could  understand  truly 
our  present  or  make  progress  without  a  knowledge  of 
that  past,  as  though  we  ourselves  were  not  part  of  history. 

So,  after  a  fashion,  I  have  in  these  pages  attempted  to 
call  back  to  life  one  little  group  of  men.  They  tell  their 
own  story,  and  if  that  story  point  a  moral,  it  is  for  you, 
kind  reader,  to  decide  and  benefit. 

In  the  development  of  the  theme  it  has  seemed  best,  for 
reasons  that  must  be  sufficiently  obvious,  not  to  bring  the 

7 


8  PREFATORY   NOTE. 

narrative  down  to  the  present  time.  It  stops  practically 
with  the  Civil  War,  or  about  the  middle  of  the  last  cen- 
tury. Certain  fugitive  chapters  are  added :  on  Ether,  on 
the  American  Medical  Association,  and  on  some  Modern 
Tendencies. 

It  has  been  decided  also  to  omit  long  lists  of  authorities, 
although  a  few  are  quoted.  An  extensive  search  and 
study  of  original  documents  has  not  been  attempted,  but 
such  works  as  came  readily  to  hand  were  used,  and  for 
no  little  material  of  the  earlier  chapters  I  am  indebted 
to  Dr.  Francis  R.  Packard's  exhaustive  and  scholarly 
"  History  of  Medicine  in  the  United  States"  (to  the  year 
1800)  recently  published.  Practically  all  the  authorities 
consulted  are  to  be  found  noted  in  the  volumes  of  the 
Index  Catalogue  of  the  Library  of  the  Surgeon-General's 
office  at  Washington. 

I  thank,  too,  most  cordially  the  Executive  Committee 
of  the  Boston  Medical  Library  for  the  courtesy  of  special 
privileges  extended  to  me;  Dr.  Francis  H.  Brown,  of 
Boston,  for  the  use  of  manuscript,  not  yet  published ;  and 
Dr.  Malcolm  Storer,  of  Boston,  for  valuable  advice  in 
revision. 

J.  G.  M. 


CONTENTS. 


PAGE 

Introduction n 

CHAPTER   I. 
The  Seventeenth  Century.     Colonial  Medicine 19 

CHAPTER   II. 
The  Eighteenth  Century.    Colonial  Medicine 40 

CHAPTER   III. 
The  Eighteenth  Century.    Colonial  Medicine  (continued)    57 

CHAPTER   IV. 
The  Eighteenth  Century.     Colonial  Medicine  (continued)     78 

Introduction  to  Chapter  V 103 

CHAPTER  V. 
The  Eighteenth  Century.    The  Revolution 106 

CHAPTER   VI. 
The  Eighteenth  Century.    Benjamin  Rush 136 

CHAPTER  VII. 
The  Eighteenth  Century.    Elihu  Hubbard  Smith 179 

CHAPTER  VIII. 

The  Eighteenth  Century.    After  the  Revolution 192 

9 


lo  CONTENTS. 

CHAPTER   IX.  PAGE 

The  Nineteenth  Century.     Early  Surgeons 203 

CHAPTER  X. 
The  Nineteenth  Century.    Early  Surgeons  (continued). . .  232 

CHAPTER  XL 
The  Nineteenth  Century.    Some  Early  Physicians  and 
THEIR  Problems 276 

CHAPTER  XII. 
The    Nineteenth    Century.      Chapman,   Francis,   Gibson, 
Jackson 329 

CHAPTER  XIII. 
The  Nineteenth  Century.     Daniel  Drake  and  the  West- 
ern Schools  369 

CHAPTER  XIV. 
The  Nineteenth  Century.     Ether,  1846 397 

CHAPTER  XV. 
The  Nineteenth   Century.     Founding  of  the  American 
Medical  Association,  1847 427 

CHAPTER   XVI. 
The  Nineteenth  Century.    Notable  Names  of  Fifty  Years  446 

CHAPTER  XVII. 
Some  Tendencies  in  Modern  Medicine 472 


INTRODUCTION. 


Throughout  history  the  man  of  action  comes  first; 
the  fighting  male,  with  his  fists,  his  club,  his  battle-axe, 
and  his  sword.  After  him  the  poet,  telling  of  his  deeds. 
Then,  after  a  long  interval,  the  philosopher  and  the  man 
of  science. 

So  Achilles  had  his  Homer,  but  no  Plato  or  Hippoc- 
rates. Reason  and  science  do  not  belong  to  the  days  of 
legend.  The  history  of  medicine  does  not  depart  from 
the  history  of  the  people.  The  brilliant  genius — the  man 
before  his  time — is  but  the  best  example  of  his  time. 

The  meaning  of  science  has  always  been  understood  by 
the  chosen  few,  and  the  inductive  method  is  as  old  as 
history;  but  legendary  Rome  did  not  produce  a  Galen, 
nor  medisevalism  a  Thomas  Huxley. 

When  we  come  down  to  the  history  of  medicine  in 
America,  we  must  remember  ^^' '  ^r  three  hundred  years 
after  its  discovery  "  -^  was  but  a  fringe  on  the  bor- 

ders of  civilization.  There  were  many  men  of  action 
here  in  those  early  days;  there  were  beginning  to  be 
some  few  poets  to  tell  the  story;  there  were  fewer  men 
of  science.  Indeed,  men  of  science  were  little  known  in 
that  Old  World  whence  we  came.  One  reads  of  doctors, 
— what  we  should  call  "practitioners," — but  scientists 
were  few.  They  were  not  liked.  There  were  many 
theories  and  systems,  but,  after  all,  such  things  interest 
us  no  more  than  the  creeds  of  that  time.  That  Van  Hel- 
mont  taught  the  doctrine  of  "  Spiritual  Vitalism"  is  of 
no  more  importance  to-day  than  that  Calvin  preached 
"  Predestination."  And  if  such  was  the  case  in  learned 
Europe,  we  must  look  for  little  in  the  wilderness. 

Let  us,  then,  glance  briefly  at  the  conditions,  political 
and  scientific,  which  obtained  especially  in  that  island 


12  INTRODUCTION. 

which  the  early  immigrants  called  home,  to  see  on  what 
the  American  medicine  of  the  seventeenth  and  eighteenth 
centuries  had  to  build. 

With  the  seventeenth  century  in  England  began  the 
unfortunate  and  futile  Stuart  dynasty  which  for  a  hundred 
years,  with  two  brief  intervals,  fought  the  losing  fight 
with  the  people  and  the  growing  spirit  of  political  free- 
dom. The  feeble,  pedantic  James,  the  shifty,  unfortunate 
Charles  I.,  the  cynical  trifler  Charles  II.,  the  bigoted 
James  II.,  and  the  dull  and  foolish  Anne  illustrate  the 
degenerate  Stuart  family,  little  qualified  to  understand 
or  deal  with  a  proud  and  progressive  people;  while  the 
remarkable  episode  of  Cromwell's  Commonwealth  and 
the  revolution  of  William  and  Mary  but  accentuate  the 
failings  of  those  others. 

Party  succeeded  party,  and  the  religious  intolerance  of 
the  one  provoked  the  religious  intolerance  of  the  other: 
Church  of  England  prelate,  Presbyterian  and  Roman 
Catholic,  persecuted,  each  in  his  turn ;  but,  through  it  all, 
constantly  there  were  coming  to  the  front  real  men,  and 
with  it  all  there  was  developing  that  intellectual  freedom 
of  which  we  now  boast. 

Then  suddenly  we  plunge  into  that  curious,  unreal 
eighteenth  century,  with  its  stupid  kings,  its  shrewd  poli- 
ticians, and  its  microscopic  literature.  A  century  of 
mediocrity  in  politics  it  was,  almost  down  to  our  Revo- 
lutionary days,  except  for  the  cyclonic  Chatham.  Cards 
and  port  ruled  in  England,  and  the  tired  dilettanteism 
of  good  society. 

To  all  those  folk  America  meant  little  more  than  Zam- 
besi land,  except  so  far  as  it  provided  comfortable  sine- 
cures for  well-born  scalawags;  and  when  the  storm  of 
1775  burst  upon  the  realm,  George  Washington  was  to 
Englishmen  Ijut  an  obscure  backwoods  colonel,  and  Benja- 
min Franklin  a  seven  days'  wonder  for  fools,  although 
a  solace  to  the  wise. 


INTRODUCTION.  13 

A  time  of  political  incubation  we  are  apt  to  think  those 
centuries  :   for  the  old  country  as  well  as  for  the  new. 

Not  altogether  darkness  for  science,  though,  was  the 
seventeenth  century  in  England.  The  brilliant  Harvey 
was  born  there  in  1578,  and  midway  in  the  reign  of  the 
foolish  James,  in  1616,  while  "  Stenie"  was  being  made 
a  Duke  of  Buckingham,  the  great  physician  was  teaching 
the  true  functions  of  the  heart  and  the  circulation  of  the 
blood.  As  truly  as  any  man,  perhaps,  was  he  the  father 
of  physiology.  And  with  Harvey  we  couple  his  famous 
contemporary,  Rene  Descartes,  who  was  the  first  to  show, 
as  Huxley  says,  that  vital  phenomena,  like  all  the  other 
phenomena  of  the  physical  world,  are,  in  ultimate  analysis, 
resolvable  into  matter  and  motion. 

In  that  century,  too,  Sydenham  and  Locke  lived  and 
taught.  Sydenham,  the  father  of  rational  medicine,  who 
was  the  first  to  show  us  moderns  the  value  of  observation 
and  the  study  of  symptoms ;  and  Locke,  student  of  physi- 
cal as  well  as  of  mental  phenomena. 

On  the  Continent,  towards  the  end  of  the  seventeenth 
century,  lived  Hoffmann,  of  Halle,  and  Boerhaave,  of 
Leyden.  Hoffmann,  the  first  to  attack  the  teaching  of 
Galen  and  the  humoral  theory;  Boerhaave,  brilliant  stu- 
dent, teacher,  philosopher,  inexhaustible  man  of  science, 
tireless  collector,  and  prophet  of  the  best  thought  of  his 
day. 

Sydenham  lived  through  the  civil  wars  and  died  the 
year  after  the  revolution  of  1688.  Boerhaave,  born  in 
1668,  lived  well  into  the  eighteenth  century  and  died  in 
1738,  in  the  reign  of  George  11. 

So  Boerhaave's  life  covered  much  of  two  centuries,  and 
brings  us  down  through  the  dawn  of  modern  science.^ 


*  Whatever  may  be  said  for  or  against  the  genius  and  scientific 
attainments  of  Sydenham  and  Boerhaave,  there  can  be  no  doubt  that 
their  influence  was  for  the  good  of  many  generations  of  physicians 
in  Europe  and  America. 


14  INTRODUCTION. 

Of  medicine  in  the  eighteenth  century  a  vast  deal  might 
be  written  and  of  the  men  who  made  it. 

In  that  century  of  memoir  writing  and  salon  philoso- 
phy, Linnaeus,  following  the  thoughts  of  Kircher  and 
Leuwenhoek,  was  considering  the  parasitic  origin  of  dis- 
ease, and  Plenciz  was  teaching  that  every  disease  has  a 
specific  infective  agent. 

Such  were  the  most  distinguished  men  of  medical 
science  known  to  us  in  those  early  days  prior  to  our  own 
Revolution,  if  we  omit  the  Hunters,  Pott,  and  other  such 
who  belong  rightly  to  a  later  time.^  The  age  was  not  a 
great  age,  perhaps,  for  scientific  progress,  as  we  reckon 
progress ;   but  progress  there  was. 

Those  men  were  struggling  out  of  an  Egyptian  dark- 
ness. There  was  no  applause  from  colleagues  and  an 
admiring  world.  Painfully,  often  in  secret,  against  preju- 
dice and  passion,  against  conservatism  and  the  traditions 
of  ages,  mostly,  those  pioneers  worked;  so  that,  to  one 
reading  the  ancient  records,  the  wonder  is  not  the  small- 
ness  but  the  greatness  of  their  deeds. 

Such  men  were  the  great  men,  the  lonely  teachers. 
Slowly  and  feebly  their  light  penetrated  to  those  others, 
the  humble  doctors  of  the  day.     To  them  and  mankind 


'  Books  required  to  be  read  by  the  candidates  for  examination 
(Massachusetts  Medical  Society,  established  June,  1808).  Anat- 
omy :  Cheselden  and  the  Edinburgh  system.  Physiology :  Haller, 
Blumenbach,  Bocrhaave,  and  Cullen.  Chemistry:  Chaptal  and 
Woodhouse.  Materia  Medica  and  Pharmacy :  Duncan's  Dispensa- 
tory ;  Massachusetts  Pharmacopoeia ;  Lewis  or  Murray's  and  Cul- 
len's  Materia  Medica.  Surgery:  Benjamin  Bell's  System;  do.  on 
Ulcers  and  on  Lues  Venerea;  John  Hunter  on  Lues  Venerea;  do. 
on  the  Blood  and  on  Gun-Shot  Wounds ;  Desault  or  Boyer  on  the 
Diseases  of  the  Bones.  Obstetrics :  Burns's  Anatomy  of  the  Gravid 
Uterus ;  on  Abortion,  Denman  or  Smellie.  Pathology  and  Thera- 
peutics: Cullen's  First  Lines  and  Nosology;  Darwin's  Zoonomia; 
Van  Swieten's  Commentaries;  Sydenham  by  Wallis;  Jackson  on 
Fevers;  Rush's  works;  Saunders  on  the  Liver;  Currie  on  Waters; 
Underwood  on  the  Diseases  of  Children ;  Pemberton  on  Diseases  of 
the  Abdominal  Viscera. 


INTRODUCTION.  15 

came  little  fresh  hope.  For  generations  men  were  born 
and  fell  sick  and  died  with  small  help  from  Harvey  and 
Sydenham,  Locke  and  Boerhaave.  That  was  the  pity  of 
it;  and  that,  perhaps,  more  than  any  one  thing,  marks 
those  days  and  these.  To  us  the  good  thing  presently  is 
known;  to  those  men  it  was  brought  only  after  years. 

One  good  thing,  however,  came  to  England  out  of  the 
East,  some  fifty-four  years  before  our  Bunker  Hill.  In- 
oculation for  smallpox,  a  practice  older  than  history,  was 
carried  by  Lady  Mary  Wortley  Montagu  and  taught  to 
Englishmen :  the  bravest  and  worthiest  thing  ever  yet 
done  by  women  teaching  medicine. 

There  were  other  men — some  of  them  very  distin- 
guished in  their  time — and  other  measures.  Wiseman 
and  Cowper  in  England  and  Le  Dran  in  France  advanced 
the  art  of  surgery.  But  enough  has  been  said  to  illustrate 
the  kind  of  times  in  which  men  were  living  and  the  kind 
of  science  which  then  prevailed. 

Now,  about  a  hundred  and  twenty  years  after  the  first 
American  voyage  of  Columbus,  one  began  to  find  scat- 
tered along  the  northern  shores  of  the  New  World  some 
feeble,  struggling  colonies,  where  Englishmen  dwelt,  at- 
tempting to  establish  permanent  homes  and  a  system  of 
government.  Their  story  and  their  measure  of  success 
it  is  needless  here  to  tell.  Suffice  it  only  to  name  those 
stations  of  theirs  where  civilization  first  took  on  some 
form  of  vigor  and  where  doctors  found  their  work. 

There  was  Virginia,  with  its  bold  John  Smith  and  the 
pretty  legend  of  Pocahontas, — all  in  the  time  of  James  I., 
whose  reign  is  made  memorable  for  us  by  the  discourses 
of  Harvey.  Virginia,  a  great  colony  of  vast  estates,  with 
a  rough,  wholesome  life  and  a  frontier  hospitality;  with 
its  negro  slavery,  its  tobacco,  its  Crown  governors,  its 
House  of  Burgesses,  and  its  Elizabethan  Society; 
changing  little,  save  for  increase  in  number  of  men  and 
in  wealth,  down  to  Revolutionary  days :    the  colony  of 


1 6  INTRODUCTION. 

Washington,  Jefferson,  Henry,  Marshall,  and  Light- 
Horse  Harry  Lee. 

Early  in  the  reign  of  Charles  I.,  and  before  the  English 
civil  wars,  came  the  first  settlements  in  the  Carolinas  to 
the  South  (long  futile),  and  at  the  same  time,  far  to  the 
north,  the  Plymouth  Colony  and  the  planting  of  Massa- 
chusetts Bay ;  with  Maryland  soon  after  and  Connecticut 
and  Rhode  Island,  all  in  quick  succession,  and  before 
active  civil  fighting  in  England.  In  Cromwell's  day  little 
colonizing  was  done;  then  came  the  restoration  of  the 
Stuarts  in  1660,  with  a  consequent  renewal  of  emigra- 
tions and  a  bountiful  bestowal  of  American  Crown  lands 
through  the  latter  years  of  the  century.  The  North  had 
been  occupied  and  the  South  had  been  occupied,  so  now 
came  the  seizing  and  settling  of  the  Middle  Colonies,  New 
York,  Pennsylvania,  and  New  Jersey. 

Rough  work,  much  of  this,  little  calculated  as  yet  for 
the  advancement  of  medical  science.  Thus  that  seven- 
teenth century  in  America  came  to  an  end :  the  seaboard 
taken  and  securely  held  by  our  vigorous  ancestors,  civil 
liberty  established,  and  the  country  prepared  for  the  pros- 
perous material  development  known  to  the  last  two  gen- 
erations of  our  colonial  days. 

To  those  two  generations  in  the  eighteenth  century  life 
grew  more  calm  and  the  Old  World  more  near.  Not  that 
there  was  lack  of  action.  French  and  Indians  on  the 
frontier  continued  a  recurring  warfare,  the  echo  of  greater 
battles  fought  beyond  the  sea.  And  out  of  it  all  grew 
constantly,  for  our  ancestors,  a  wider  experience,  a  closer 
touch  with  Europe,  a  sense  of  increasing  strength  and 
importance,  an  independence  of  thought,  and  an  intol- 
erance of  control  leading  at  last  to  political  freedom 
through  the  American  Revolution. 

For  the  purpose  of  this  narrative  we  divide  roughly  the 
colonial  days  of  America  into  two  eras,  and  those  eras 
correspond  with  the  two  centuries  of  which  I  have  told : 


INTRODUCTION.  17 

the  seventeenth  century,  a  time  of  colonization,  struggle, 
and  privation,  when  a  footing  was  being  made  on  these 
shores ;  the  eighteenth  century,  when  towns  were  building 
and  farms  were  planting,  when  commerce  was  beginning 
to  thrive,  and  schools  and  colleges  were  appearing  in  the 
land. 

So  we  must  expect  to  find  the  medical  history  of  the 
one  era  quite  distinct  from  that  of  the  other.  At  first  the 
practice,  remote  and  inadequate,  of  Elizabethan  England 
was  brought  here ;  then,  with  the  succeeding  century  and 
the  upgrowing  of  generations  of  American-born  men, 
came  a  wider  knowledge,  better  general  education,  and  the 
first  feeble  attempts  to  combine  the  wisdom  and  teaching 
of  the  Old  World  with  the  changed  experience  of  the 
New. 


A   NARRATIVE 


OF 


MEDICINE   IN   AMERICA. 


CHAPTER    I. 

THE    SEVENTEENTH    CENTURY.       COLONIAL    MEDICINE. 

The  Englishmen  brought  their  doctors  with  them  when 
they  came  to  settle  Virginia,  and  the  Jamestown  of  1607 
had  three  members  of  the  faculty.  Thomas  Wotton,^ 
Surgeon-General  of  the  London  Company,  came  out  with 
the  expedition  which  sailed  from  England  on  December 
19,  1606, — a  most  uncomfortable  season  we  must  sup- 
pose. "  Chirurgeon"  Captain  John  Smith  calls  him,  and 
ranks  him  with  the  "  Gentlemen"  of  the  expedition.  Gen- 
tlemen surgeons  were  little  known  to  our  ancestors  three 
hundred  years  ago.  Those  ancient  surgeons  were  barbers 
first,  and  "  gentleman  barber"  sounds  strangely  even  to 
modern  ears.^  Now,  Wotton  was  a  surgeon  certainly, 
but  beyond  the  name  and  fact  we  know  no  more. 

It  is  of  some  interest  to  consider  for  a  moment  what 
this  surgeon  and  "  Gentleman  Adventurer" — the  first  of 


^Roswell  Park,  following  Stith,  calls  him  "  Woolton."  I  know- 
not  why. 

"  It  was  an  ancient  custom  for  the  patient,  when  being  bled,  to 
grasp  firmly  in  his  hand  an  upright  pole,  in  order  to  stimulate  the 
flow  of  blood.  As  the  pole  was  apt  to  become  stained,  a  white  linen 
band  was  twisted  about  it,  and  it  was  hung  outside  the  door  of  the 
barber's  shop.  Our  patriots  have  added  a  blue  to  the  red  and  white 
stripes. 

19 


20  MEDICINE    IN   AMERICA. 

his  kind  to  visit  these  shores — stands  for  in  American 
medicine.  The  adventure  was  beset  with  hazard  and 
hardship  of  a  kind  unknown  to  our  modern  world.  It 
was  an  association  of  bold  and  roving  spirits,  joined 
together  for  an  attack  upon  the  distant,  fearsome  wilder- 
ness. The  life  was  of  the  hardest  and  the  recompense 
unknown.  The  voyage  itself  entailed  a  weariness  and 
distress  now  almost  inconceivable.  So  let  us  believe  that 
the  surgeon  of  the  little  fleet  was  a  man  of  high  heart  and 
vigor,  worthy  predecessor  of  that  long  line  of  resourceful, 
able  men  who  have  honored  American  science. 

The  year  1606  was  the  third  year  of  poor  James;  the 
penal  laws  against  papists  were  being  passed,  and  the 
plague  was  in  London.  Harvey  had  not  yet  announced 
his  great  discovery.  Indeed,  the  world  was  very  young. 
Earlier  comers  to  Virginia,  under  Raleigh,  had  had  no 
surgeon  with  them.  Cause  and  efifect  we  may  not  find  in 
this;  but  misfortune,  hardship,  and  disease  so  thinned 
their  ranks  that  no  permanent  settlement  was  made.  John 
Smith's  adventurers,  with  their  Wotton,  fared  better. 
Perhaps  he  "  signified." 

A  pleasant  speculation,  all  this,  no  doubt;  but  Wotton 
was  the  first  of  our  pioneer  doctors,  and  we  must  make 
the  most  of  him. 

Besides  Wotton,  the  surgeon,  other  doctors  came  to 
these  shores.  With  the  "  First  Supply"  followed  "  Doc- 
tor" Walter  Russell,  perhaps  a  man  of  science  and  holding 
a  degree.  Doubtless,  Wotton  returned  to  England, 
leaving  to  Russell  all  the  medical  cares.  Two  colonies 
claim  the  latter,  for  in  June,  1608,  Captain  Smith,  with  a 
small  company  of  fourteen,  explored  the  Chesapeake. 
Among  them  went  Russell,  and  so  came  to  Maryland  and 
the  "  Eastern  Shore." 

In  the  story  Smith  tells  of  the  first  medical  aid  given 
to  Englishmen  in  the  land.  A  few  days  later  "  it  chansed 
our  Captaine  taking  a  fish  from  his  sword  (not  knowing 


THE  SEVENTEENTH  CENTURY.     21 

her  condition)  being-  much  of  the  fashion  of  a  Thorn- 
back,  but  a  long  tayle  hke  a  riding  rodde,  whereon  the 
middest  is  a  most  poysoned  sting,  of  two  or  three  inches 
long,  bearded  like  a  saw  on  each  side,  which  she  strucke 
into  the  wrist  of  his  arme  neare  an  inch  and  a  halfe :  No 
blood  nor  wound  was  seene,  but  a  little  blew  spot,  but  the 
torment  was  instantly  so  extreme,  that  in  foure  houres  had 
so  swolen  his  hand,  arme  and  shoulder,  we  all  with  much 
sorrow  concluded  his  funerall,  and  prepared  his  grave  in 
an  Island  by,  as  himselfe  directed :  yet  it  pleased  God  by 
a  prescious  oyle  Doctor  Russell  at  the  first  applyed  to  it 
when  he  sounded  it  with  the  probe  (ere  night),  his  tor- 
menting paine  was  so  well  asswaged  that  he  eate  of  the 
fish  to  his  supper,  which  gave  no  less  joy  and  content  to 
us  than  ease  to  himselfe,  for  which  we  called  the  Island 
Stingray  Isle  after  the  name  of  the  fish." 

That  story  and  these  notes  you  will  find  to  be  typical 
of  the  times.  The  professional  life  of  a  few  distant  colo- 
nial doctors  is  too  obscure  to  be  dignified  with  the  name 
of  history  and  an  extensive  narrative ;  mostly  they  played 
their  humble  parts  with  hundreds  of  others,  and  are  con- 
signed to  a  blameless  oblivion. 

In  this  same  year  1608  Anthony  Bagnall,  "  Chirur- 
geon,"  sailed  with  Smith  upon  the  Chesapeake;  but  of 
him  and  Russell,  as  of  Wotton,^  we  hear  little.  Three 
adventurous  spirits,  let  us  believe,  they  appear  to  us  out 
of  the  mists  of  those  early  days,  and  disappear. 

Then  came  Dr.  Lawrence  Bohun  in  16 10,  and  Dr.  John 
Pott  in  1624,  temporary  governor  in  1628. 

In  the  histor}^  of  medicine  great  names  stand  forth  and 
mark  events,  but  in  the  early  history  of  American  science 
great  names  are  lacking  and  great  events  as  well.     So  the 


'  Toner  mentions  "  Dr.  James  Woolton"  as  Surgeon-General  of 
the  colony  in  1607.  Probably  he  means  that  Thomas  Wotton,  "  Chi- 
rurgeon,"  of  Captain  Smith's  narrative. 


22  MEDICINE    IN    AMERICA. 

interest  to  us  is  not  so  much  in  the  men  and  what  they 
did  as  what  kind  of  men  they  were  and  what  the  hfe 
they  led. 

In  Virginia  we  find  them  coming  in  scattered  ships, 
rarely,  adventurous,  often  returning  home;  then  infre- 
quently to  settle,  to  take  up  the  life  of  the  wilderness,  to 
bear  their  part  with  other  pioneers,  humble,  little  honored 
in  history.  Names  dear  to  Dryasdust  but  of  small 
moment  to  others. 

But  whatever  the  individual  merits  of  the  early  Vir- 
ginia doctors,  they  made  a  beginning  of  one  good  work, 
the  completion  of  which  still  lies  heavily  upon  us.  They 
stirred  up  the  Assembly  to  pass  laws  regulating  medical 
practice.  This  was  in  1639,  when  the  Legislature  of  the 
colony  was  but  twenty  years  old,  the  year  before  the  sum- 
moning of  that  famous  Long  Parliament  of  Charles  I. ; 
and  further  laws  they  passed  in  1661,  the  year  after  the 
restoration  of  Charles  II.  Of  what  value  these  laws  may 
have  been  it  is  impossible  now  to  say,  but  they  were  needed 
sadly  enough. 

Throughout  the  colonies  quackery  flourished  luxu- 
riantly with  little  let  or  hindrance.  The  gi'eat  distances, 
the  infrequent  needs  of  the  people,  the  lack  of  any  high 
medical  standard,  and  the  loose  methods  and  credulity 
of  most  of  the  regularly  licensed  men  gave  an  oppor- 
tunity to  what  we  pleasantly  call  "  irregular  practitioners" 
such  as  to  this  day  the  country  has  not  outgrown. 

That  first  law,  passed  on  October  21,  1639,  was  "an 
act  to  compel  physicians  and  surgeons  to  declare  on  oath 
the  value  of  their  medicines." 

So  Virginia  was  the  first  to  tiy  some  feeble  beginning 
of  reform ;  and  to  one  glancing  back  over  those  early 
chaotic  days  Virginia  must  be  remembered  for  these  two 
facts:  that  thither  came  the  first  surgeon,  Wotton,  whom 
we  know ;  and  that  there  first  the  law  demanded  better 
things. 


THE  SEVENTEENTH  CENTURY.     23 

Now,  there  is  something  good  for  which  we  may  re- 
member that  fooHsh  James  in  whose  reign  Harvey  taught. 
He  it  was  who  issued  patents  to  the  London  Company 
for  the  South  and  to  the  Plymouth  Company  for  the 
North;  and,  having  remembered  this,  we  need  think  of 
him  no  more. 

To  Virginia  came  the  two  surgeons  and  Dr.  Russell ; 
but  not  until  1620,  thirteen  years  later,  was  the  science 
of  Europe  brought  to  Plymouth  in  Massachusetts  Bay. 
Dr.  Samuel  Fuller  was  the  bearer  of  that  science, — a  man 
of  some  moment,  let  us  believe ;  versatile,  devoted,  a  true 
Pilgrim  in  the  land.  Some  few  words  about  this  ancient 
Fuller  must  be  said,  because  he  stands  for  a  type  notable 
in  those  early  New  England  days,  and  because  the  prac- 
tice of  the  man  illustrates  well  the  science  of  the  times 
in  which  he  lived.  The  light  we  get  upon  him  is  not  veiy 
clear.  Patience,  faith,  and  imag'ination  are  needed  to 
project  one's  twentieth-century  \'ision  into  the  mind  of  a 
simple,  credulous  countiy  doctor  of  the  seventeenth 
century. 

Samuel  Fuller  was  a  church  deacon — no  sinecure  in 
those  days,  but  the  important  business  of  life.  Dr. 
Green  ^  guesses  that  he  would  have  preferred  the  title 
"  Deacon"  to  that  of  "  Doctor."  Very  likely.  Indeed, 
there  is  no  evidence  that  he  held  the  JNI.D., — a  rare  dis- 
tinction here  in  that  centurv\;  so  "Deacon  Fuller"  he 
doubtless  was.  The  story  of  that  first  winter  in  Plymouth 
needs  no  telling  here,  but  we  must  believe  that  there  was 
enough  practice  for  Deacon  Fuller  and  his  faithful  wife. 
He  was  the  first  physician  in  New  England,  for  some  time 
the  only  one,  and,  most  happily  for  the  community  other- 
wise so  sad  and  stricken,  he  had  brought  a  scanty  stock 
of  drugs.     He  came  here,  then,  among  the^  first,  already 


*  S.  A.  Green,  A  Centennial  Address.  Medical  Communications  to 
the  Massachusetts  Medical  Society,  1881. 


24  MEDICINE    IN    AMERICA. 

grown  mature,  practised  for  thirteen  years,  and  died.  His 
wife  was  taught  his  work  in  some  rough  sort, — to  act  as 
midwife  at  least, — and  both  together  served  their  neigh- 
bors well. 

It  was  told  with  pride  that  Deacon  Fuller's  medical 
duties  took  him  even  to  Salem  and  Charlestown,  and  that 
his  opinion  was  held  in  high  esteem  by  Governor  Endi- 
cott.  Many  of  the  people  were  afflicted  with  "  scui"vy  and 
other  distempers"  peculiar  to  their  hard  circumstances, 
and  Deacon  Fuller  went  among  them  and  "  met  with 
great  success  in  his  practice." 

Hard,  constant  physical  work,  long  hours,  heat  and 
cold ;  all  that,  as  well  known  now  as  then,  we  must  believe 
he  bore.  Besides,  he  did  some  farming  and  wrestled  long 
in  prayer. 

We  cannot  help  surmising  what  the  mental  state  could 
be  of  those  ancient  doctors  when  they  planned  their 
curious  remedies.  In  all  seriousness.  Sir  Kenelm  Digby 
wrote  to  the  younger  John  Winthrop  this  recipe;  it  illus- 
trates the  times  and  minds  of  men  in  1656 : 

"  In  the  mean  time  let  me  tell,  you  of  an  easy  medicine 
of  mine  owne  that  I  have  seene  do  miraculous  cures  in  all 
sorts  of  vlcers  and  in  mending  soddainly  broken  bones  wch 
I  conceive  it  doth  by  carrying  awaye  by  vrine  the  ichorous 
matter  that  infesteth  such  maladies ;  and  then  nature  heal- 
eth  and  knitteth  apace,  when  nothing  hindereth  her.  It 
is  this :  Beate  to  a  subtile  pouder  one  ounce  of  Crabbes 
eyes  (in  latin  called  oculi  cancorum)  then  put  upon  it  in 
a  high  glasse  (because  of  the  ebullition)  fore  ounces  of 
strong  vinegar.  It  will  instantly  boyle  up,  extremely :  let 
it  stand  till  all  be  quiett — then  strain  it  through  a  fine 
linon — and  of  this  liquor  (wch  will  taste  like  dead  beere 
without  any  sharpness)  give  two  spoonfuls  att  a  time  to 
drink  three  times :  and  you  shall  see  a  strange  effect,  in  a 
weeke  or  two." 

Just  one  more  and  we  need  not  worry  ourselves  further 


THE  SEVENTEENTH  CENTURY.     25 

with  such.  This  is  from  the  receipt-book  of  John  Wads- 
worth,  of  Duxbury : 

"  This  Receipt  cost  me  fifty  pounds  by  count,  and  I  pray 
yt  you  would  not  expose  the  same  without  good  fee :  this 
for  a  canser  proves  exelant,  and  if  in  time  apphed  will  cure 
a  canser  humor.  Take  3  frogs  and  put  ym  into  a  deep 
airthen  Basen  and  power  upon  them  as  much  swete  oyel 
as  will  cover  them,  put  ym  into  a  hot  oven  and  let  ym 
stand  a  quarter  of  an  houre :  then  turn  off  the  remaining 
oyel  and  dip  tow  in  it  and  apply  to  the  canser ;  and  for  a 
plaster  you  must  take  the  yolkes  of  2  eggs.  Burnt  Allow, 
I  oz.  Boal  armonick,  i  oz.,  Bay  salt  one  half  oz.  Bruse 
all  to  a  fine  pouder  and  mix  up  with  yr  yolkes  of  eggs  and 
apply  in  form  of  a  plaster  to  the  sore  every  3d  day.  Give 
a  portion  of  a  spoon  of  salts  to  cool  the  hete  of  the  Blood ; 
this  alwaise  will  carry  off  a  canser  humor  if  timely  applied : 
the  person  must  make  them  constant  Drink  canser  roots 
tea.  .  .  .  We  may  att  sartain  times  apply  a  tode  cutt  in 
two  to  the  wound  two  or  three  times  a  week  the  nature  of 
yr  tode  is  such  yt  will  draw  out  the  sharp  hot  canserous 
and  pysonous  and  if  you  proseded  in  this  matter  you  may 
cure  any  canser."  ^ 

These  two  dreary  recipes  feebly  illuminate  several 
phases  of  ancient  practice.  The  absolute  ignorance  of  the 
nature  of  cancer  and  its  diagnosis,  as  well  as  of  the  action 
of  the  proposed  remedies,  is  not  surprising;  but  the  credu- 
lity of  the  writers  is  amazing  and  carries  us  very  far  back 
into  the  dark  ages.  Whatever  the  preposterous  practices 
of  our  ancestors  during  the  past  two  centuries,  the  best 
of  them  certainly  have  not  trusted  blindly  to  their  own 
remedies  nor,  like  quacks,  boasted  their  virtues. 

And  then  that  paying  fifty  pounds  for  a  secret  remedy ! 
The  remedies  are  curious  and  amusing,  if  you  choose,  but 


"  Francis  H.  Brown,  M.D.,  The  Practice  of  Medicine  in  New  Eng- 
land before  the  year  1700,  in  manuscript. 


26  MEDICINE    IN   AMERICA. 

they  show  us  how  far  removed  as  yet  was  medicine  from 
science. 

Truly  that  was  an  era  of  barbarism,  though  it  struggled 
towards  the  light.  Harvey  was  living  and  Descartes. 
The  truth  was  being  sought,  but  as  yet,  for  us  in  rude 
America,  crudeness  and  error  reigned. 

So  Deacon  Fuller  died.  The  records  note  two  other 
facts.  For  near  a  hundred  years  the  births  of  children 
were  supervised  by  women — midwives  they  called  them. 
Some  sort  of  skill,  perhaps,  they  had.  And  largely  medi- 
cine was  held  in  part  the  work  of  ministers,  and  statesmen 
took  a  hand.  The  Massachusetts  exodus  was  thoughtfully 
prepared.  In  planning  emigration,  the  clergy  sought  to 
learn  their  duty  to  the  body  as  well  as  to  the  soul.  "  Medi- 
cal missionaries"  would  be  our  term.  Highly  trained  and 
scholarly  the  records  call  them ;  doubtless  they  were,  but 
we  have  gleaned  some  knowledge  of  the  science  of  that 
day.  The  statesman,  trained  in  medicine,  who  interests 
us  most  was  John  Winthrop,  Jr.,  who  was  born  in  1605 
and  in  1657  became  Governor  of  the  New  Haven  Colony. 
Harvey's  contemporary  almost,  he  studied  medicine  before 
his  coming  here,  perhaps  with  that  great  master.  Of 
good  repute  in  science,  let  us  think,  because  he  became  a 
founder  of  the  Royal  Society. 

It  is  hard  to  say  what  may  have  been  the  medical  ser- 
vice and  value  of  Winthrop  to  the  colonists,  but  it  would 
seem  that,  like  Endicott  and  Winslow,  the  latter  of  whom 
is  also  reckoned  among  the  doctors,  he  Avas  rather  a  Board 
of  Health  and  a  general  supervisor  than  a  constant  active 
practitioner,  summoning  other  physicians  in  time  of  stress 
and  taking  their  advice. 

We  must  remember,  too,  that  the  women  of  that  day, 
both  gentle  and  simple,  professed  some  skill  in  drugs  as 
well  as  in  midwifei*y,  and  that,  like  the  Drumtochty  folk, 
the  people  called  a  doctor  only  for  their  dire  needs. 

What  avails  it,  then,  to  name  names?     The  supply  of 


THE  SEVENTEENTH  CENTURY.     27 

physicians  increased  constantly  with  the  growth  of  the 
colonies.  In  the  three  generations  prior  to  1692  Savage 
mentions  one  hundred  and  thirty-four  men  who  were 
doctors,  in  name  at  least.  So  says  Oliver  Wendell 
Holmes,  after  painful  search.  J.  M.  Toner,  the  most 
careful  student  of  American  medical  annals  known  to  me, 
and  F.  H.  Brown  give  exhaustive  lists.  So  those  ancient 
men  are  rescued  from  oblivion, — mostly  to  little  purpose.*^ 

Some  few  are  better  known  for  other  things  than  medi- 
cine. Presidents  of  Harvard  College  were  among  them, 
like  John  Rogers  and  Leonard  Hoar,  or  the  bearers  of 
fanious  names,  like  Henry  Saltonstall,  son  of  Sir  Richard. 

To  me  the  most  interesting  is  humble  Robert  Morley, 
of  whom  we  read  this :  that  it  was  "  agreed  with  Robert 
Morley,  servant  to  Mr.  Andrew  Mathews,  late  Barber 
Surgeon,  to  serve  the  Company  in  New  England  for  three 
years,  the  first  year  to  have  20  nobles,"  etc. 

That  is  a  grievous  fact,  to  surgeons  notable ;  but  it 
was  common  enough.  Indeed,  it  was  not  only  the  barber 
surgeon  who  became  servant  to  some  man,  but  the  distin- 
guished and  learned  physician  had  his  patron.  Han^ey, 
Locke,  and  Sydenham  knew  their  masters.  To  us,  who 
feel  science  to  be  the  most  important  work  of  men,  all 
this  may  seem  humiliating ;  but,  after  all,  it  was  not  so  to 
them.     Our  art  held  no  great  place  in  people's  eyes.    The 


*  Here  is  a  list  of  eighteen  of  them,  perhaps  the  best-known  Mas- 
sachusetts physicians  of  the  seventeenth  century :  John  Fisk,  of 
Salem,  arrived  1637;  Giles  Fairman,  of  Boston,  1634;  Robert  Child, 
arrived  1639;  William  Gager,  of  Boston,  1630;  Comfort  Starr,  of 
Cambridge,  1638;  Samuel  Bellingham,  Harvard  College,  1642; 
Leonard^Hoar,  President  of  Harvard  College,  1672 ;  Henry  Salton- 
stall, Harvard  College,  1642;  John  Glover,  Harvard  College,  1650; 
Charles  Chaunce3^  President  of  Harvard  College,  Ph-mouth,  1638; 
John  Rogers,  President  of  Harvard  College,  16S2 ;  Samuel  Seabury, 
Duxbury  Circ,  1650;  James  Oliver,  Boston  Circ,  1640;  John  Pratt, 
of  New  London,  1636;  John  Clark,  Sr.,  of  Boston,  1650;  John  Wil- 
son, Harvard  College,  1642 ;  Thomas  Boylston,  of  Brookline,  died 
1695 ;    Robert  Morley. 


28  MEDICINE    IN   x\MERICA. 

church  came  first  and  then  the  law.  A  great  nobleman 
was  a  very  real  thing  indeed,  and  taken  seriously  in  ances- 
tral England.  But  now  what  matters  who  their  masters 
were?  Sydenham  and  Locke  we  know,  and  even  plain, 
wise  Stubbe;  but  who  their  patrons  were,  what  mortal 
cares  ? 

The  surgeon  was  subordinate  to  the  physician  until 
long  after  those  days.  That  is  another  curious  distinction 
of  the  time  before  clear  scientific  reasoning.  The  occult, 
obscure,  metaphysical,  unprovable  thing,  about  which  men 
might  wrangle  through  their  lives :  that  was  held  quite 
fine  and  dignified — the  most  worthy  calling ;  but  the  thing 
capable  of  clear  physical  proof,  which  appealed  to  the 
senses  readily,  which  one  could  run  and  read :  that  was 
deemed  unworthy  of  great  minds.  So  the  pompous,  mys- 
terious physician  was  a  great  man;  the  practical,  pro- 
gressive, useful  surgeon  a  humble  barber. 

That  tells  us  why  for  all  those  years  surgery  so  out- 
stripped medicine  in  real  advance.  What  the  surgeon 
knew  he  first  must  prove,  and  so  he  kept  his  feet  on  solid 
earth.  The  vaporings  of  those  other  theorists  gave  medi- 
cine no  rock  on  which  to  build.  The  first  real  forward 
movement  in  the  physic  of  to-day  began  when  physicians 
learned  that  they  must  use  their  senses.  And  when  to 
the  unaided  senses  they  could  add  instruments  of  pre- 
cision, then  the  ground  became  very  firm  indeed.  What 
is  the  feeble  eye  without  the  microscope,  or  what  the  touch 
without  the  thermometer  ? 

Such  are  the  thoughts  that  come  to  mind  in  reading 
of  those  days.  The  Wottons,  Fullers,  Winthrops,  Mor- 
leys,  Clarks,  press  blameless  on  according  to  their  lights. 

So  much  for  New  England  in  the  first  struggling  cen- 
tury,'''    A  time  of  sternness  and  high  faith  it  was,  and 


^Russell's  Recollections  of  the  Pilgrims;    Pell's  Annals  of  Salem; 
Winthrop's  Journal. 


THE  SEVENTEENTH  CENTURY.     29 

much  credulity;  untouched  by  one  great  falsehood, 
though.  We  cannot  learn  that  even  then  physicians  aided 
or  abetted  Mather  in  persecuting  witches  and  the  like. 
Though  they  made  no  protest,  for  their  good  judgment, 
be  it  said,  they  nowhere  sided  with  the  madness.  The 
first  person  executed  for  witchcraft  was  Margaret  Jones, 
physician  and  doctress.  It  appeared  "  that  she  had  such  a 
malignant  touch  as  many  persons  were  taken  with  deaf- 
ness or  vomiting  or  other  violent  pain  or  sickness,  her 
medicines,  though  harmless  in  themselves,  yet  had  ex- 
traordinarily violent  effects,  that  such  as  refused  her  medi- 
cines she  would  tell  that  they  would  never  be  healed." 
Truly  a  most  irregular  and  short-sighted  person ;  but  she 
expiated  her  sins. 

The  fate  of  Mistress  Jones  connects  her  with  this  narra- 
tive not  other^vise  than  that  she  was  a  doctress. 

Another  note  of  those  times,  observed  by  all  writers,  is 
the  fact  that  long  before  the  witchcraft  business  the  first 
American  medical  publication  of  which  we  have  record 
appeared  in  Boston :  "  A  Brief  Rule  to  guide  the  Common 
People  of  New  England  How  to  order  themselves  and 
theirs  in  the  Small  Pocks  or  Measles,"  by  the  Reverend 
Thomas  Thacher,  the  first  minister  of  the  Old  South 
Meeting-House.  One  must  think  well  of  the  patience  and 
cultivation  of  the  "  Common  People"  in  those  days.  The 
"  Brief  Rule"  wanders  sadly  through  four  difficult  col- 
umns, a  very  miracle  of  words  and  obscurity. 

This  much  becomes  salient  when  we  think  of  the  New 
England  medicine  of  the  seventeenth  century:  that  the 
immigrants  brought  with  them  the  best  they  could  from 
the  Old  World,  Deacon  Fuller  leading  them ;  that  many 
doctors  came  among  us  in  proportion  to  our  numbers, 
mostly  educated  in  England ;  some  few  were  of  ourselves, 
instructed  here  in  private,  no  college  of  medicine  being 
yet  established ;  fewer  still  of  our  young  men  went  abroad 
seeking  the  degree;   and  finally,  in  Boston  was  first  pub- 


30  MEDICINE    IN   AMERICA. 

lished  that  brief  medical  tract  of  which  the  successors  now 
flood  the  land. 

So,  leaving  Massachusetts  Bay,  let  us  proceed  to  see 
in  what  rough  way  the  other  colonies  were  coming  on. 

One  cannot  tell  the  story  of  American  medicine  as  a 
whole,  especially  in  those  early  years.  There  was  no 
whole,  such  as  England  or  France  could  show.  There 
was  no  Capitol.  As  each  colony  developed  its  own  politi- 
cal existence,  so  it  developed  its  medical  annals ;  most 
especially  in  the  early  days,  when  little  intercourse  ex- 
isted between  the  colonies.  There  were,  however,  four 
principal  medical  centres  before  the  Revolution;  and,  if 
we  count  Virginia  and  Maryland,  there  were  six;  but 
the  principal  centres  were  naturally  the  leading  seaboard 
cities,  New  York,  Philadelphia,  Boston,  and  Charleston. 

Let  us  turn  to  New  York,  perhaps,  even  in  those  days, 
the  most  interesting  of  our  towns,  and  see  in  what  manner 
medicine  was  faring  there. 

New  York  was  the  only  one  of  the  thirteen  American 
colonies  which  ever  changed  owners, — owners  with  white 
skins,  of  course;  we  never  count  our  copper-colored 
friends.  It  not  only  changed  owners,  but  it  changed  its 
people  and  its  language.  From  1608  to  1664  it  was  all 
Dutch ;  from  then  on  it  was  English,  except  for  the  brief 
Dutch  irruption  of  1673, — a  nearly  equal  division  of  time 
in  that  century.  So  we  find,  as  we  might  expect,  Dutch 
doctors  and  English  doctors  and  some  few  Huguenot 
doctors  in  New  York  before  1700.  They  were  men  of 
education  quite  similar  to  that  of  their  New  England 
neighbors,  some  few  of  whom,  indeed,  had  made  a  sojourn 
in  Holland  on  their  way  hither. 

Now,  the  New  Netherlands,  like  the  English  colonies 
to  north  and  south,  was  controlled  at  first  by  a  company — 
the  Dutch  West  India  Company  (succeeding  the  United 
New  Netherlands  Company) — which  began  its  colonizing 
in  1 62 1,  and  by  all  these  companies  there  was  some  pro- 


THE  SEVENTEENTH  CENTURY.     31 

vision  made  for  the  medical  care  of  the  pioneers.  Here 
is  what  the  Charter  of  the  Dutch  Company  provided : 

"  The  Patrons  and  Colonists  shall  in  particular,  and  in 
the  speediest  manner  endeavor  to  find  ways  and  means 
whereby  they  may  support  a  minister  and  school  master; 
and  thus  the  service  of  God  and  zeal  for  religion  may  not 
grow  cool  and  be  neglected  among  them;  and  that  they 
do  for  the  first  procure  a  comforter  for  the  sick,"  etc. 

"'  A  comforter  for  the  sick;"  truly  a  quaint  and  pleasant 
thought.  Many  to-day  are  wont  to  feel  that  such  is 
woman's  work.  But  the  first  comer  was  not  that  sort  of 
a  comforter;  he  was  a  ship  surgeon,  Mynderts  van  de 
Bogaerdet  by  name,  sailing  on  the  "  Endragh"  in  1631. 
Like  our  Virginia  Wotton,  he  came  and  went.  Then  in 
1637  came  one  of  another  type,  such  as  was  Deacon  Fuller 
in  Massachusetts, — a  steady,  well-equipped  man,  a  Hu- 
guenot and  "  gentleman,"  Johannes  La  Montague.  This 
was  the  year  before  William  Kieft  was  appointed  gov- 
ernor, and  began  that  active  opposition  to  the  English  on 
the  Connecticut  and  to  the  Swedes  and  English  at  the 
South,  which  ended  only  in  1664. 

Those  years  in  the  '30's  are  interesting,  for  they  mark 
many  events.  In  1630  came  the  settlement  of  Boston, 
and  the  same  year  the  Carolina  grant;  in  1632  the  Mary- 
land grant;  in  1633  Wentworth  and  Laud  began  that 
series  of  arbitrary  acts  which  led  to  civil  war;  in  1636 
Harvard  College  was  founded, — the  first  American  col- 
lege. In  the  same  year  came  the  establishment  of  the 
Providence  Plantations  and  the  New  Jersey  grant.  The 
year  1637,  in  England,  was  marked  by  the  trial  of  John 
Hampden  for  his  refusal  to  pay  ship  money,  by  the  frus- 
trated attempt  of  Hampden,  Pym,  and  Cromwell  to  sail 
for  America,  and  here,  by  the  arrival  of  La  Montague  at 
Manhattan  Island.  In  1638,  in  Scotland,  was  the  signing 
of  the  Solemn  League  and  Covenant,  and  in  America  the 
beginnings  of  the  Rhode  Island  and  New  Haven  colonies. 


32  MEDICINE    IN   AMERICA. 

In  1639  the  Virginia  Assembly  passed  that  first  medical 
bill  of  which  we  have  made  note. 

A  strange  mingling  of  small  things  with  great,  all  this. 
Politics  outweighed  science;  but  the  times  were  full  of 
life  and  expansion  had  begun. 

It  was  in  such  days  that  our  Huguenot  gentleman  came 
to  New  Amsterdam  and  took  up  his  vocation  as  "  a  com- 
forter for  the  sick"  :  the  first  New  York  physician. 

As  with  most  of  those  early  doctors  here,  we  know 
little  of  M.  La  Montague.  He  wrote  nothing  medical  of 
moment,  but  he  followed  the  best  practice  of  his  times. 
He  is  described  as  learned  and  skilful.  Now,  there  are 
two  suggestive  facts  about  the  doctors  who  went  earliest 
to  New  Amsterdam.  The  stress  of  their  surroundings 
forced  them  into  all  sorts  of  practice, — into  surgery  as 
well  as  medicine, — so  that  they  acquired  the  kind  of  prac- 
tical facility  which  surgery  alone  can  give ;  and  they  were 
mostly  active  in  the  affairs  of  the  colony  as  office-holders 
and  magistrates.  Those  were  primitive  days ;  the  authori- 
ties were  very  considerable  personages  and  were  held  in 
respect,  and  we  must  believe  that  our  physicians  were 
advanced  to  positions  of  trust  and  dignity  because  they 
were  men  of  ability  who  improved  their  talents.  Such  a 
one,  doubtless,  was  La  Montague;  at  once  prominent,  it 
appears,  for  in  1641,  only  four  years  after  his  coming,  he 
was  sent  with  fifty  men  on  that  fruitless  expedition  to 
defend  Fort  Good  Hope,  by  the  Connecticut  River,  against 
the  expanding  Puritan  English,  an  expedition  fruitless, 
but  significant  of  many  things.  So  he  returned.  He 
remained  prominent  in  office,  we  are  told,  and  let  us  trust 
that,  like  Deacon  Fuller,  he  met  with  "  good  success  in 
practice." 

La  Montague  was,  however,  not  alone  in  Manhattan. 
The  year  after  his  coming  there  arrived  Gerrett  Schult 
and  Hans  Kierstede,  surgeons.  This  was  in  1638.  The 
latter  lived  down  to  1661,  almost  to  the  end  of  the  Dutch 


THE    SEVENTEENTH    CENTURY. 


33 


days.  Then  there  was  Samuel  Megapolensis,  born  in  this 
country,  graduated  from  Harvard  in  1657,  ^^^  ^^  M.D. 
of  Utrecht;    a  minister  as  well. 

There  were  very  few  others;  the  colony  was  a  small 
one,  and  if,  for  the  sake  of  impartiality,  we  name  Abra- 
ham Staats,  Vanevenger,  L'Orange,  J.  Hughes,  Jan  du 
Parck,  Gerardus  Beekman,  and  Alexander  C.  Curtis,  there 
is  nothing  more  to  say.  The  English  name  Curtis  strikes 
us  and  the  French  L'Orange ;  but,  after  all,  they  made  no 
history,  and,  even  with  the  coming  of  the  English,  they 
changed  not,  but  went  their  several  ways,  Beekman  living 
until  1724. 

With  the  coming  of  the  English,  however,  a  law  of 
practice  was  put  forth  of  interest  to  us,  because,  like  the 
Virginia  law  of  1661,  it  was  an  earnest  forward  step; 
futile,  indeed,  since  it  demanded  proficiency,  but  provided 
no  cure  for  inefficiency.  Such  as  it  was,  though,  it  pro- 
voked Yankee  admiration,  and  came  shortly  to  be  copied 
verbatim  on  the  statute  books  of  Massachusetts  Bay.^ 

'  Duke  of  York's  Laws,  1665,  The  General  Laws  and  Liberties  of 
the  Massachusetts  Colony,  Cambridge,  1672.  "  It  is  therefore  ordered 
that  no  person  or  persons  whatsoever,  employed  at  any  time  about  the 
bodyes  of  men,  women  or  children  for  the  preservation  of  life  or 
health :  as  Chirurgeons,  Midwives,  Physicians  or  others,  presume 
to  exercise  or  put  forth  any  act  contrary  to  the  known  approved 
Rules  of  Art,  in  each  Mystery  and  Occupation,  nor  exercise  any 
force  violence  or  cruelty  upon  or  towards  the  body  of  any  whether 
young  or  old  (no  not  in  the  most  difficult  and  desperate  cases)  with- 
out the  advice  and  consent  of  such  as  are  skilful  in  the  same  Art 
(if  such  may  be  had)  or  at  least  of  some  of  the  wisest  and  gravest 
then  present,  and  the  consent  of  the  patient  or  patients  if  they  be 
mentis  compotes,  much  less  contrary  to  such  advice  and  consent. 
Upon  such  severe  punishment  as  the  nature  of  the  fact  may  deserve ; 
which  Law  never-the-less  is  not  intended  to  discourage  any  from 
all  lawful  use  of  their  skill,  but  rather  to  encourage  and  direct  them 
in  the  right  use  thereof,  and  to  inhibit  and  restrain  the  presump- 
tuous arrogancy  of  such  as  through  presidence  of  their  own  skill 
or  any  other  sinister  respects,  dare  boldly  attempt  to  exercise  any 
violence  upon  or  towards  the  bodyes  of  the  young  or  old,  one  or  the 
other,  to  the  prejudice  or  hazard  of  the  life  or  limbe  of  man  woman 
or  child." 


34  MEDICINE    IN    AMERICA. 

One  more  name  let  us  glance  at  in  the  English  period : 
Johannes  Kerf  by  le,  of  Ley  den,  notable  only  because  he 
made  an  autopsy  (medico-legal)  which  is  on  record, — • 
erroneously  said  to  have  been  the  earliest  in  America. 

That  is  the  brief  story  of  the  seventeenth-century 
Knickerbocker  men,  and  they  differed  from  their  Yankee 
brethren  in  this  respect  only,  that,  in  proportion  to  their 
numbers,  more  of  them  held  University  degrees.*^ 

As  in  the  case  of  Virginia  and  New  England,  those 
feeble  New  York  beginnings  of  simple  country  doctors 
led  the  way  to  a  wider  science.  Quickly  with  the  opening 
of  another  century  we  pass  to  greater  things;  meantime 
let  us  say  one  word  of  our  other  colonies  struggling 
towards  modern  times. 

Of  all  the  American  colonies,  Pennsylvania  started  in 
most  thoroughly  equipped  with  what  we  call  the  necessi- 
ties of  life.  It  came  into  existence  later  than  most  of  the 
other  thirteen,  its  pioneers  found  themselves  already  sur- 
rounded by  a  kindred  folk,  and  much  of  its  mountains  and 
forests  had  already  been  explored;  it  therefore  offered 
peculiar  advantages  to  settlers  who  were  neither  "  adven- 
turers" nor  martyrs,  and  its  equipment  was  that  of  a 
well-rounded  community.  It  had  but  eighteen  years  of 
the  seventeenth-century  life,  however,  so  that  its  record  is 
a  short  one.  When  Penn  landed  at  New  Castle,  the  third 
generation  of  white  men  was  growing  up  in  Boston,  New 
York  had  been  British  for  nearly  twenty  years,  and  Vir- 
ginia was  an  old  colony  with  wide-spreading  plantations 
and  an  experienced  Legislature. 

Something,  too,  might  be  said  of  the  settlements  that 
struggled  feebly  on  the  Delaware  (or  South  River)  before 
Penn's  days.  Indeed,  one  cannot  omit  telling  of  the  visits 
to  New  Jersey  of  George  Fox,  the  Quaker  leader,  in  1672, 


"  History  of  the  New  Netherlands ;    Documentary  History  of  New 
York;    Broadhead's  History  of  the  State  of  New  York. 


THE  SEVENTEENTH  CENTURY.     35 

and  of  his  famous  surgical  case.  That  excellent  enthu- 
siast recounts  how  his  fellow-traveller,  John  Jay,  was 
thrown  from  his  horse  and  had  his  neck  broken : 

"  I  got  to  him  as  soon  as  I  could,  and  feeling  on  him 
concluded  that  he  was  dead.  As  I  stood  pitying  him  and 
his  family,  I  took  hold  of  his  hair,  and  his  head  turned 
any  way,  it  was  so  limber.  Whereupon,  throwing  away 
my  stick  and  gloves,  I  took  his  head  in  both  my  hands  and 
setting  my  knee  against  the  tree,  I  raised  his  head  and  per- 
ceived there  was  nothing  out  or  broken  that  way.  Then 
I  put  one  hand  under  his  chin  and  the  other  behind  his 
head,  and  raised  his  head  two  or  three  times  with  all  my 
strength  and  brought  it  in.  I  soon  perceived  his  neck 
began  to  grow  stiff  again  and  then  he  began  to  rattle  in  his 
throat,  and  quickly  after  to  breathe.  .  .  .  The  next  day  he 
was  pretty  well  and  many  hundreds  of  miles  did  he  travel 
with  us  after  this."  ^^  This  is  an  interesting  story,  told 
in  truthful  style,  and  to  the  surgeon  highly  credible,  as 
if  there  had  been  a  dislocation  of  atlas  upon  axis. 

Ten  years  later  than  George  Fox,  William  Penn  came 
up  the  Delaware  to  establish  a  popular  government  and 
make  his  treaty  with  the  Indians.  With  him  and  his  com- 
pany of  one  hundred — a  third  of  whom  died  of  smallpox 
on  the  voyage  —  came  Dr.  Thomas  Wynne,  an  accom- 
plished Welshman.  If  we  can  trust  the  records,  Wynne 
was  the  most  thoroughly  equipped  and  learned  physician 
who,  until  then,  had  visited  America.  The  same  we  have 
found  to  be  said  of  La  Montague,  the  Huguenot  gentle- 
man, and  of  various  New  Englanders.  Now,  our  knowl- 
edge of  these  worthies  is  gleaned  from  obituaries  and 
biographies,  not  always  the  most  truthful  sources  of  infor- 
mation; often  the  tributes  of  grateful  patients.  So  it 
comes  about  that  the  medical  historian,  groping  after  facts, 
lights  often  upon  a  smooth  but  treacherous  way.     One 


'Journal  of  George  Fox,  London,  1694,  p.  370. 


36  MEDICINE    IN    AMERICA. 

began  to  tell  the  greatness  of  good  Deacon  Fuller,  but  Ad- 
mirable Montagne  and  Erudite  Wynne  have  thrown  us  all 
aback.  Let  us  compromise,  then,  with  the  probable  truth, 
that  all  of  them  were  notable  in  their  communities  of 
earnest,  laborious  men;  useful  and  prominent  as  good 
citizens  rather  than  distinguished  as  scientists  and  leaders 
in  their  art. 

It  was  too  soon  yet  to  look  for  greater  things.  Indeed, 
what  American  statesman  or  jurist  or  clergyman  of  those 
days  was  marked  in  distant  Europe?  Of  Cotton  Mather 
some  had  heard,  and  there  their  knowledge  ceased. 

There  are  two  facts  worthy  of  knowledge  about  those 
earliest  Philadelphia  doctors.  In  some  way  many  were 
kinsmen, — nearly  all  were  Welshmen, — and  they  founded 
American  families  which  in  one  line  or  other  have  per- 
sisted to  this  day.  More  than  in  New  York  or  Boston, 
medicine  has  been  a  popular  and,  in  some  sort,  a  socially 
distinguished  profession  in  Philadelphia.^^  Among  such 
founders  were  Dr.  Daniel  Wills,  who  was  in  Burlington  in 
1682;  and  Dr.  Edward  Jones,  in  1682,  who  married  a 
daughter  of  Wynne.  In  turn,  his  daughter,  Mary  Wynne 
Jones,  married  John  Cadwalader,  whose  descendants  still 
remain. 

Equally  conspicuous  with  Dr.  Wynne  was  Dr.  Thomas 
Lloyd,  a  cultivated  Welshman,  who  came  here  in  1683. 
He,  too,  held  high  colonial  rank,  —  Deputy-Governor 
(himself  protesting  much).  President  of  the  Council,  and 
Keeper  of  the  Great  Seal.  Of  them  all,  though,  Griffith 
Owen  was  the  most  "  successful  in  practice,"  a  friend  of 
Penn ;   in  politics  an  active,  forceful  man. 


"  Even  before  Wynne  there  were  other  doctors.  Among  the  early 
Swedes  on  the  Delaware  were  Hans  Janche,  1644,  and  Timon  Stid- 
dem,  1654.  Among  the  Dutch  were  Jan  Oosten,  1657,  and  William 
van  Rasenberg,  1658  (Casper  Morris  in  Memoirs  of  the  Historical 
Society  of  Pennsylvania,  1826,  vol.  i.  p.  350)  ;  and  still  others  were 
Wetherill,  Stacy,  Collins,  and  Abraham  Pierson,  Newark,  1667. 


THE  SEVENTEENTH  CENTURY.     37 

Such  were  the  men  who  brought  medicine  to  the  found- 
ing of  Philadelphia.  Of  a  generation  and  a  learning  be- 
yond the  pioneer  doctors  of  other  colonies,  they  usher  in 
the  expansion  of  another  century,  to  which  they  properly 
belong. 

In  reading  the  medical  annals  of  our  country,  one  real- 
izes quickly  and  vividly  how  small  and  feeble  we  were 
before  the  year  1700.  New  England,  Virginia,  and  New 
York  had  seen  the  birth  of  three  generations ;  so,  too,  per- 
haps, had  Maryland ;  but  Pennsylvania  and  even  the  Caro- 
linas  were  new.  New  Jersey  and  Delaware,  though  not 
so  young,  were  unformed,  and  all  the  rest  was  wilderness 
to  English-speaking  men.  So  we  see  that  of  the  doctors 
and  their  records  in  those  days  there  is  little  to  say.  Of 
Mainland  there  should  be  a  word,  and  of  Baltimore,  so 
proudly  placed  to-day  in  the  scientific  world;  but  her 
seventeenth-century  record  is  all  but  inarticulate.^^  That 
ancient  Walter  Russell,  who  cured  John  Smith  with 
"  oyle,"  is  claimed  by  Maryland  on  account  of  that  very 
deed  done  on  her  soil ;  two  or  three  others  are  named,  but 
there  are  no  more  until  we  pass  by  near  a  century.  Some- 
what the  same  is  true  of  Charleston.  There  centred  nearly 
all  the  learning  south  of  the  James  River  for  very  many 
years;  but  for  us  Charleston's  records  count  for  nothing 
until  we  pass  the  1700  mark. 

It  is  not  altogether  easy  to  say  just  what  were  the 
colonial  conditions  calling  for  medical  service  in  the  seven- 
teenth century.  Children  were  born  without  troubling  the 
doctors  much,  we  know;  but  after  the  survival  of  the 
fittest  in  those  first  strenuous  years  the  ordinary  trifling 
ailments  so  familiar  to  an  overcrowded  civilization  were 
very  little  known.  The  sturdy  frontier  folk,  leading  a  life 
of  exposure,  much  in  the  open,  ignorant  of  cities,  had 
little  need  of  doctors  except  for  the  major  ills.    They  were 


'  J.  R.  Quinan,  Medical  Annals  of  Baltimore  from  1608  to  1880. 


38  MEDICINE   IN    AMERICA. 

educated  in  the  rudiments,  intelligent,  and  not  afraid  to 
work  witli  their  hands.  The  homely  life  of  the  day  was 
free,  if  not  joyous.  Earnest,  God-fearing  men  who  drove 
the  plough,  read  their  Bibles,  and  sent  the  eldest  son  to 
Harvard  College,  and  women  who  treasured  bits  of  family 
silver,  discussed  the  state  of  the  elect,  and  did  their  own 
cooking  were  not  likely  to  be  the  parents  of  dyspeptic 
girls  or  boys,  unable  to  stand  the  rigors  of  the  time. 

We  read,  however,  of  grievous  surgical  conditions  and 
fierce  epidemics  sweeping  over  the  land.  Smallpox,  yel- 
low fever,  scurvy,  "  typhus"  (much  of  which  seems  to 
have  been  typhoid),  dysentery,  influenza,  and  the  various 
contagious  eruptive  fevers  of  childhood  were  the  foes  with 
which  the  doctors  mostly  had  to  contend ;  and,  as  we  may 
suppose,  their  practice  did  not  differ  from  that  familiar  to 
the  Europe  of  their  time. 

In  the  New  York  and  New  England  records  especially 
we  find  many  accounts  of  such  epidemics,  which  some- 
times reached  the  most  serious  proportions.  New  Eng- 
land more  than  the  others  was  invaded  by  smallpox,  the 
first  recorded  visitation  of  which  seems  to  have  swept  off 
hundreds  of  Indians  a  few  years  before  the  landing  of 
the  Pilgrims  in  1620.  Douglass,  in  his  "  Summary," 
mentions  ten  epidemics.  New  York  suffered  in  the  same 
way,  but  was  singularly  free,  says  Colden,  from  consump- 
tion and  other  pulmonary  diseases. 

So,  epidemics  were  most  common  in  the  Northern  colo- 
nies, where  ships  came  often  to  the  larger  ports;  though 
the  Carolinas,  Virginia,  and  Maryland  did  not  altogether 
escape.  In  1699  Philadelphia  was  wasted  by  a  grievous 
outbreak  of  Barbadoes  fever,  which  may  have  been  yellow 
fever,  though  that  is  by  no  means  clear. 

The  medical  literature  dealing  with  such  matters  was 
developed  in  the  eighteenth  century.  No  useful  medical 
essays  and  few  accurate  descriptions  were  written  before 
1700.    The  "  plagues"  that  came  were  often  "  the  hand  of 


THE    SEVENTEENTH    CENTURY. 


39 


the  Lord"  shown  in  wrath.  Folk  suffered  and  endured, 
but  of  comments  there  were  few.  We  can  see,  though, 
that,  in  spite  of  their  scant  medical  learning,  those  old 
doctors  were  brave  and  faithful  men,  devoted  to  their 
people  and  no  mean  comforters  of  the  sick.  The  lapse  of 
years,  the  change  in  modern  thought,  in  dress,  in  lan- 
guage almost,  confuse  our  vision  and  our  point  of  view; 
but  those  were  very  real  and  human  folk, — our  ancestors ; 
their  doctors  knew  them  well ;  they  waited  patiently,  and 
time  brought  better  things. 


CHAPTER     II. 

THE    EIGHTEENTH    CENTURY.       COLONIAL    MEDICINE. 

On  January  i,  1801,  Dr.  David  Ramsay,  the  historian, 
read  before  the  Medical  Society  of  South  CaroHna,  at 
Charleston,  "  A  Review  of  the  Improvements,  the  Prog- 
ress, and  the  State  of  Medicine  in  the  Eighteenth  Cen- 
tury." Painfully  one  struggles  through  his  pompous 
periods  and  obscure  phrasing;  but  one  fact  stands  out 
luminous,  that  at  the  end  of  the  eighteenth  century  even  so 
careful  a  student  as  Ramsay  knew  little  of  the  accomplish- 
ments of  his  immediate  predecessors.  Just  as  to-day  most 
of  us  think  of  the  times  before  Lister  and  Pasteur  as  be- 
longing to  the  Dark  Ages,  so  a  hundred  years  ago  Rush 
was  the  prophet  and  former  times  were  of  small  moment. 
Yet  those  former  times,  like  former  times  in  all  ages,  were 
needed  for  the  better  things  to  come. 

The  hidden  currents  which,  since  the  Renaissance,  had 
been  sweeping  towards  the  political  and  intellectual  en- 
franchisement of  the  eighteenth  century  were  not  unfelt 
by  science,  and  the  American  colonies  of  Great  Britain 
got  their  share. 

To  one  who  observes  the  progress  of  the  race  it  appears 
that  political  and  scientific  development  are  apt  to  go  hand 
in  hand.  So  it  was  with  us,  and  the  cause  is  obvious 
enough.  With  the  larger  life  and  expanding  fortunes  of 
the  colonies,  from  1700  to  1775,  democratic  thought  be- 
gan to  prevail  at  the  same  time  that  rational  observation, 
deduction,  and  record  began  to  be  made.  Then  came  the 
Revolution,  marking  an  era  in  our  science  as  important, 
almost,  as  in  our  politics;  not  so  violent,  perhaps,  but  no  , 
less  certain. 
40 


THE   EIGHTEENTH    CENTURY.  41 

When  one  thinks  of  the  progress  of  events  in  the  Amer- 
ica of  that  centui"y  during  the  first  seventy-five  years,  one 
finds  that  wars  and  rumors  thereof  occupied  very  much 
of  the  time.  From  1702  to  171 3  there  was  Queen  Anne's 
war;  for  the  next  twenty-five  years,  though  there  was 
nominal  peace,  the  Indians  ceased  not  their  troubhng. 
From  1739  to  1748  the  Spanish  war  exercised  mostly  the 
South,  especially  Oglethorpe's  new  colony  of  Georgia; 
and  the  French  war  of  1744- 1748  was  signalized  in  New 
England  annals  by  the  first  capture  of  Louisburg.  Then 
came  the  "  Old  French  and  Indian  War,"  most  familiar 
in  colonial  histoiy,  bringing  fame,  good  or  bad  as  the  case 
might  be,  to  Braddock,  Washington,  Franklin,  Montcalm, 
Loudon,  Webb,  Abercrombie,  Johnson,  Amherst,  Howe, 
and  Wolfe. 

There  are  other  names  which  it  behooves  us  to  note 
somewhat :  humble  names  mostly,  of  small  account  to  the 
historians,  but  something  to  us;  names  honorable  in 
science;  some  two  or  more  worthy  even  of  record  by  the 
writer  of  great  events.  Golden,  Lieutenant-Governor  of 
New  York,  contributed  something  of  value ;  Shippen  and 
Morgan  did  the  same  in  Pennsylvania ;  so,  too,  did  Boyl- 
ston  and  Mather  in  Massachusetts,  and  Chalmers,  Bull, 
Moultrie,  Lining,  and  Garden  in  South  Carolina.  Those 
are  the  men  to  whom  American  medicine  in  the  eighteenth 
century  owes  most,  and  they  may  be  remembered  for  these 
four  things :  they  introduced  inoculation  for  smallpox, 
they  made  a  beginning  of  our  medical  literature,  they 
established  medical  schools,  and  they  laid  the  foundations 
of  hospitals.  Small  things,  all  of  them,  perhaps,  contrasted 
with  those  warlike  events  and  names,  but  looming  larger 
with  the  lapse  of  years. 

The  story  is  a  simple  one  when  all  is  told,  though  not 
without  value  to  the  student  of  men. 

When  the  eighteenth  century  opened  the  population  of 
the  English  colonies  in  North  America  was  about  three 


42  MEDICINE    IN   AMERICA. 

hundred  thousand ;  when  it  closed  the  United  States  num- 
bered nearly  four  millions;  and  at  the  beginning  of  that 
era,  of  all  the  foes  our  ancestors  faced, — hardship,  famine, 
pestilence,  Indian  and  foreign  wars, — the  most  dreaded 
was  smallpox. 

In  these  days  of  public  hygiene  few  of  us,  laymen  or 
physicians,  appreciate  the  ancient  prevalence  of  smallpox 
and  the  dread  of  it  always  present  in  the  hearts  of  men. 
One  writer  ^  has  said  that  if  an  observant  modem  man 
could  be  transported  to  the  London  streets  of  a  hundred 
years  ago,  the  most  noticeable  thing  he  would  observe 
about  the  men  and  women  would  be,  not  the  dress  or 
language  so  much  as  the  ever-present  pock-marked  faces. 
For  centuries,  even  before  the  dawn  of  history,  smallpox 
raged.^  Sixty  per  cent,  of  mankind  were  attacked  by  it 
and  ten  per  cent,  died  of  it.^ 

In  the  time  of  the  epidemics  whole  villages  were  depop- 
ulated and  savage  tribes  were  annihilated.  Its  spread 
was  world-wide.  The  Persian  Rhazes,  in  the  ninth  cen- 
tury, was  the  first  to  write  clearly  of  it ;  but  the  Chinese 
tell  of  ravages  centuries  before  that,  and  claim  the  use  of 
inoculation  as  early  as  a.d.  59. 

Like  most  ancient  diseases,  it  was  said  to  come  from 
the  East, — from  India,  probably,  the  home  of  the  race. 
By  some  writers  it  is  thought  to  have  remained  there 
endemic,  and  not  to  have  reached  Europe  until  brought  by 
the  returning  Crusaders.  America,  at  any  rate,  was  free 
from  it  in  the  old  Indian  days ;  but  soon  after  the  coming 
of  Columbus  it  spread  to  the  Western  Hemisphere,  ap- 
pearing first  in  the  West  Indies  in   1507.     The  island 


'  Macaulay. 

°  Stephen  Brown,  of  New  York.  Prize  essay  on  Smallpox,  Ameri- 
can Medical  Recorder,  January,  1809. 

"  August  Hirsch,  Hand-Book  of  Geographical  and  Historical 
Pathology. 


THE    EIGHTEENTH    CENTURY. 


43 


Indians  died  of  it  like  sheep;  among  no  people  was  the 
mortality  ever  so  great. 

Smallpox  soon  spread  to  the  Continent.  The  English- 
men found  it  here  when  they  came.  Indeed,  that  famous 
pestilence  which  invaded  New  England  shortly  before  the 
Pilgrims  arrived  was  smallpox,  without  doubt. 

Says  Cotton  Mather, — 

"  The  Indians  in  those  parts  had  newly,  even  about  a 
Year  or  Two  before,  been  visited  with  a  prodigious  Pesti- 
lence as  carried  away  not  a  Tenth,  but  Nine  Parts  of  Ten 
(yes,  'tis  said  Nineteen  of  Twenty)  among  them  so  that 
the  Woods  were  almost  cleared  of  those  pernicious  Crea- 
tures to  make  room  for  a  better  Growth."  '^ 

But  the  pestilence  did  not  spare  the  "  better  Growth." 
No  sooner  were  the  English  settlements  made  than  small- 
pox began  to  be  known  in  their  midst.  Douglass  reports 
a  series  of  epidemics.  There  was  the  Indian  one  of 
1 617,  when  the  Pawkunnawkutts  and  Massachusetts 
were  nearly  wiped  out  of  existence.^  Then  those  later 
epidemics  which  befell  the  colonies  in  1633,  1663,  1666, 
1668,  1677,  1688,  1690,  and  1702, — grievous  years  for 
our  ancestors,  long  to  be  remembered,  and  carrying  deso- 
lation to  thousands  in  the  infant  colonies. 

Two  of  the  most  notable  advances  in  the  science  and 
practice  of  medicine  which  have  been  made  in  this  coun- 
try originated  in  Boston.  Both  received  their  initial  im- 
•  pulse  from  men  not  strictly  within  the  ranks  of  physicians, 
and  from  both  arose  notorious  controversies  and  scandals 
almost  without  precedent  in  modern  science. 

In  the  first  half  of  the  eighteenth  century  the  intro- 
duction of  inoculation  for  the  smallpox  rent  the  profes- 
sion and  society  as  well.     In  the  first  half  of  the  nine- 


*  Magnalia,  Book  I.,  Chapter  ii.  p.  7. 

°  Packard  and  other  writers  question  the  diagnosis,  but  the  evi- 
dence points  most  strongly  to  smallpox. 


44  MEDICINE   IN   AMERICA. 

teenth  century  the  introduction  of  ether  anaesthesia  raised 
a  storm  of  jealousy  and  controversy  which  to  this  day  has 
hardly  subsided. 

In  some  sort,  the  first  of  these  events  was  so  conspicu- 
ous and  so  important  in  medical  annals  that  the  story  of 
it  and  of  the  men  concerned  illuminates  those  days.  The 
leading  dramatis  persona;  were  four,  one  of  them  already 
notable.  Cotton  Mather;  the  others  were  William  Doug- 
lass, Zabdiel  Boylston,  and  Lawrence  Dal  'Honde.  There 
were  many  lesser  ones;  youthful  Benjamin  Franklin  most 
articulate  among  them. 

Some  brief  words  of  these  men  must  needs  be  said. 

Cotton  Mather,  the  distinguished  politician  and  divine, 
is  too  well  known  to  need  remark,  and  the  recent  work 
of  Mr.  Barrett  Wendell,  instinct  with  life,  has  brought 
him  familiarly  to  modern  sight.  In  1721,  the  year  of 
the  inoculation  fight,  he  was  beginning  to  grow  old,  the 
"  Magnalia"  was  many  years  written,  and  the  witches  had 
long  been  burned.  Still,  his  active  mind  concerned  itself 
with  many  things,  not  least  of  all  with  the  science  of  the 
day. 

William  Douglass  was  one  of  the  most  interesting  Bos- 
tonians  of  the  first  part  of  the  eighteenth  century.^  In 
certain  ways  he  reminds  one  of  Cotton  Mather:  obsti- 
nate, pessimistic,  a  hard  fighter,  a  good  hater,  a  worker; 
but  a  scamp,  perhaps,  certainly  a  liar.  Everything  one 
hears  of  him  is  either  good  or  bad.  He  was  born  in  Scot- 
land about  1690.  His  education  was  broad,  in  the  old 
sense.  He  was  graduated  in  medicine  and  afterwards 
spent  some  time  on  the  Continent,  especially  in  Paris,  for 
study  and  observation.  Then  he  drifted  to  the  West 
Indies  and  America.  Passing  through  the  middle  colo- 
nies, which  he  disliked,  lie  came  at  last  to  Boston,  which 


"T.   L.   Jennison,    in   his   Life  of   William   Douglass,   praises   him 
without  stint. 


THE    EIGHTEENTH    CENTURY.  45 

he  despised,  and  there  he  settled.  The  wonder  is  that  he 
stayed  there;  he  detested  the  Puritans,  their  creed,  their 
mode  of  thought,  and  their  manner  of  hfe.  As  simple 
James  Thacher,  with  pleasant  lack  of  humor,  puts  it,  "  his 
notions  of  religion  were  very  loose  and  unsettled." 

On  his  coming  to  Boston,  Douglass  began  at  once  to 
bestir  himself  in  various  ways.  He  was  far  from  inar- 
ticulate, and  with  the  insolent  freedom  of  a  youthful  trav- 
eller he  aired  his  opinions  of  men  and  affairs.  His  intro- 
ductions were  good,  and  he  was  an  ill  man  to  overlook. 
He  had  brought  letters  to  Mather,  but  Mather  snubbed 
him.  Here,  indeed,  the  trouble  began.  It  was  in  1718 
that  he  came  to  Boston.  Three  years  before  the  inocula- 
tion days, — three  years  not  wasted  by  our  adventurous 
Scot, — busy  with  tongue  and  pen,  he  had  become  a  per- 
sonage ere  ever  the  trouble  began.  Of  him  more 
later. 

Perhaps  the  most  distinguished,  if  not  the  most  interest- 
ing physician  of  the  little  Boston  group  of  those  days  was 
Zabdiel  Boylston,  an  orthodox  person  certainly,  very 
properly  and  securely  placed.  His  father,  Dr.  Thomas 
Boylston,  an  Englishman  with  the  M.D.  of  Oxford,  had 
settled  in  Brookline,  Massachusetts,  in  1635,  the  year  be- 
fore the  founding  of  Harvard  College,  and  in  Brookline 
the  son  Zabdiel  was  born  in  1684/  so  that  he  was  about 
six  years  the  senior  of  the  irascible  Douglass. 

If  we  are  to  follow  the  record  of  the  credulous  Thacher, 
young  Boylston  studied  medicine  with  his  father,  to  whom 
we  must  credit  not  only  astonishing  physical,  but  abnormal 
mental  powers,  for  he  played  the  pedagogue  in  his  nine- 
tieth year.  The  son  also  studied  with  Dr.  John  Cutter, 
a  man  of  some  local  reputation,  and  to  him,  doubtless,  he 
owed  most.     That  he  received  the  doctor's  degree  does 


^  The  son  of  an  ancient  man,  it  would  appear ;    but  the  dates  as 
given  by  Thacher  seem  correct. 


46  MEDICINE    IN    AMERICA. 

not  appear.  A  studious,  earnest,  intelligent  man  he  proved 
himself,  at  all  events ;  given  to  botany  and  kindred  pur- 
suits ;  married  to  Jerusha  Minot,  and  the  father  of  many- 
children. 

It  is  a  great  name  in  Boston,  with  some  reason,  let  us 
believe,  for  he  represents  that  type  of  steady  conservatism 
joined  to  scholarship  and  readiness  to  accept  the  new  in 
demonstration  which  we  admire  in  all  ages.  Some  touch 
of  genius,  too,  he  must  have  had;  certainly  he  saw  his 
occasion  and  seized  it, — his  hand  turned  to  the  need  of 
the  hour,  his  eye  betimes  on  the  distant  future.  Surviving 
the  present  storm,  he  lived  for  many  years,  outlasting  his 
old  adversaries, — Douglass  among  them, — converted  at 
last;  and  he  died  almost  at  the  end  of  the  colonial  chap- 
ter, in  1766. 

Much  less  notable  than  the  men  already  mentioned  was 
Lawrence  Dal  'Honde,  a  busy  Boston  physician.  We 
know  very  little  of  him  beyond  his  connection  with  the 
inoculation  business.  He  was  a  Frenchman  who  had  had 
a  long  career  with  the  armies  of  his  own  people ;  a  check- 
ered career,  it  seems,  profitable  for  the  experience  of 
larger  things  it  gave  him.  In  the  year  1721  he  was  no 
longer  young, — fifty  years  old  at  least ;  but  a  strong,  bit- 
ter, and  perhaps  unscrupulous  partisan.  His  opponents 
say  that  he  told  lies,  which  is  doubtless  true,  though  there 
is  no  special  evidence  of  that  in  the  quotation  which  tliey 
cite. 

Such  were  the  four  men,  as  we  gather  their  obscure,  dis- 
torted histor)'-;  very  human,  indeed,  and  of  types  not 
always  associated  with  our  notions  of  Puritan  Boston. 

There  is  something  in  the  nature  of  our  race  that 
prompts  us  passionately  to  oppose  the  man  who  comes  to 
remedy  great  evils.  History  is  full  of  such  evidences. 
The  case  of  Socrates  is  not  unique ;  but,  after  all,  the  truth 
at  length  prevails.  In  their  blind  anger  men  sacrifice  their 
benefactors,  and  then  deify  them  when  convinced  at  last 


THE    EIGHTEENTH    CENTURY.  47 

that  no  false  prophet  was  there.  It  is  the  charlatan  and 
impostor  that  we  fear ;  so  we  kill  the  man  of  good  works, 
and  later  tell  how  he  was  no  knave. 

Something  of  the  old  story  came  near  being  told  in 
Boston  in  those  early  days,  wath  Boylston  as  the  victim 
and  Douglass  in  the  role  of  malignant  high-priest.  The 
tragedy  was  not  played  out;  no  blood  was  spilt,  but  not 
from  lack  of  appetite.  . 

When  Lady  Mary  Wortley  Montagu  came  from  Con- 
stantinople in  1 72 1,  and  told  in  London  about  the  Turkish 
inoculation  for  the  smallpox,  it  w^as  promptly  discovered 
by  the  wise  that  there  is  nothing  new  under  the  sun.  Some 
form  of  inoculation  had  been  practised  for  centuries 
among  the  peasantry  in  South  Wales.  They  called  it 
"  buying  the  smallpox,"  and  they  pricked  the  virus  in 
with  pins.  In  the  Highlands  of  Scotland,  too,  the  prac- 
tice was  not  unknown.  There  the  operation  was  per- 
formed by  tying  infected  threads  about  the  waists  of 
children.  The  antiquity  of  the  custom  among  Oriental 
peoples  is  well  vouched  for. 

But  all  this  after-thought  is  beside  the  mark.  It  is  not 
antiquity,  but  authority  which  counts  in  therapeutics  as 
in  most  other  things  of  the  world,  and  the  authority  of 
Lady  Mary  Wortley  Montagu  and  her  sponsors  first  gave 
inoculation  a  place  among  thoughtful  people.  Not  with- 
out opposing  tumult,  however;  heathen  and  Christian 
raged  fiercely.  The  common  people  were  frightened,  the 
learned  were  sceptical  and  bitter,  and  the  clergy  preached 
against  subverting  the  decrees  of  Providence  and  resisting 
the  punishments  of  God.  The  sword  of  the  Lord  and  of 
Gideon  was  held  over  the  heads  of  the  impious  innovators. 
Indeed,  the  reverend  gentlemen  vicariously  dispensed 
damnation  with  a  freedom  and  assurance  that  would  have 
done  credit  to  their  Puritan  grandfathers. 

In  1732  the  Reverend  Mr.  Massey  preached  from  the 
text  of  Job  ii.  7 :  "  So  went  Satan  forth  from  the  presence 


48  MEDICINE    IN    AMERICA. 

of  the  Lord,  and  smote  Job  with  sore  boils  from  the  sole 
of  his  foot  unto  his  crown,"  concluding  that  "  the  cuta- 
neous disease  of  Job  was  produced  by  inoculation  from 
the  hands  of  the  devil,  and  the  whole  art  was  of  infernal 
invention." 

We  are  familiar  with  the  vulgar  opposition  to  vaccina- 
tion at  the  present  day, — an  opposition  based  on  fanati- 
cism and  ignorance,  though  rarely  fierce;  so  we  may 
imagine  the  virulence  of  the  fight  against  inoculation  two 
hundred  years  ago,  based  on  a  legitimate  fear  of  contagion 
and  worked  up  to  a  fantastic  terror  by  popular  ignorance 
and  superstition.  The  same  scenes  were  enacted  the  world 
over :  professional  outcries,  clerical  diatribes,  legislative 
discussions,  and  mob  violence. 

Our  American  ancestors  have  taken  credit  to  themselves 
that  the  institution  of  inoculation  sprang  up  de  novo,  as  it 
were,  in  our  midst;  not  the  gradual  spread  to  our  shores 
of  a  practice  tried  and  proved  in  Europe,  but  started  vol- 
untarily and  originally  by  our  own  people.  Cotton 
Mather  was  at  the  bottom  of  it,  and  his  part  in  the  propa- 
ganda was  not  the  least  honorable  effort  of  his  active  and 
varied  career.  The  occasion  brings  the  man,  and  it  was 
so  in  this  case. 

When  AVilliam  Douglass  came  to  Boston  he  brought  an 
introduction  to  Mather,  as  we  have  seen,  but  was  never 
able  to  make  headway  in  that  quarter.  The  strenuous 
old  theologian  took  no  interest  in  the  voluble  young  scep- 
tic, and  though  Douglass  was  forced  to  admire,  and  tried 
to  cultivate  the  elder  man,  the  compliment  was  in  no  way 
returned.  Still,  Douglass  sought  him  out  and,  among 
other  evidences  of  his  regard,  supplied  him  with  the  more 
recent  scientific  literature  of  the  day,  brought  by  him  from 
London.  Among  such  papers,  Mather  read,  in  the  early 
days  of  1721,  when  smallpox  was  beginning  to  prevail  in 
Boston,  the  famous  paper  by  Timonius,  on  "  Turkish  In- 
oculation."   To  the  student  of  medical  history  it  is  no  sur- 


THE   EIGHTEENTH    CENTURY.  49 

prise  to  learn  that  the  paper,  hitherto  almost  unnoticed, 
was  already  four  years  old. 

Dr.  Emanuel  Timoni  Alspeek,  who  was  graduated  both 
at  Padua  and  at  Oxford,  was  residing  in  Constantinople 
in  the  year  1703,  and  was  then  struck  by  the  instances 
which  he  witnessed  of  the  mitigated  nature  of  smallpox 
when  the  virus  was  artificially  communicated  to  the  hu- 
man frame.  He  wrote  an  account  of  his  observations  to 
Dr.  Woodward,  by  whom  it  was  inserted  in  the  Philo- 
sophical Transactions  of  the  year  171 7.  Pilarini,  a  Vene- 
tian physician,  also  published  in  171 5,  at  Venice,  a  state- 
ment of  the  success  of  the  Turkish  practice. 

At  the  present  day,  with  the  rapid  advance  of  medical 
science  and  with  the  daily  press  teeming  with  tales  of  new 
discoveries  and  methods,  we  know  how  frequently  the 
imagination  of  the  average  layman  is  fired  by  the  idea 
of  some  new  "  cure,"  and  we  know  what  humbug  it  all 
is,  mostly.  Somewhat  the  same  conditions  obtained  in 
those  old  days  of  Mather,  probably ;  the  laymen  exploited 
and  the  doctors  scoffed,  for  it  was  the  layman  Mather 
who  was  fired,  and  the  professionals  would  have  none 
of  it. 

Mather's  fire  was  as  pardonable  as  his  method  of  going 
to  work  was  most  courteously  ethical.  He  neither  prac- 
tised nor  preached,  but  went  about  his  task  in  an  ortho- 
dox manner.  First  he  sent  for  his  brisk  young  acquaint- 
ance, Douglass,  to  whom  he  owed  his  discovery,  and 
told  him  what  he  had  found.  Would  Douglass  under- 
take the  work  ?  No,  Douglass  would  not,  and  the  prosaic 
historian,  despite  himself,  gives  us  some  feeble  vision  of 
the  strenuous  scene :  the  old  scholar,  earnest,  convinced, 
dogmatic,  insistent;  the  young  scientist,  incredulous, 
scoffing,  obstinate,  angered  that  this  chance  for  a  brilliant 
coup  should  have  slipped  through  his  fingers  to  be  seized 
by  a  prying  layman,  and  determined  to  minimize  for  his 
own  purposes  the  value  of  the  find.    It  was  all  too  uncer- 

4 


50 


MEDICINE    IN    AMERICA. 


tain  and  too  new,  he  said.  The  community  would  not 
submit  to  the  hazard,  and  the  evidence  in  its  favor  was 
too  scant. 

So  the  interview  ended  with  wrath  on  one  side,  with 
snubs  on  the  other.  But  the  old  churchman  had  his  blood 
up.  If  Douglass  would  not  do  it,  he  would  find  some  one 
who  would.  The  fight  was  on  and  it  was  to  the  knife. 
Without  delay  he  went  about  it,  and  approached  succes- 
sively the  leading  physicians  of  the  town.  It  was  all  of 
no  avail.  Douglass  had  secured  the  ear  of  his  colleagues 
and  of  the  public  press.  But  the  clergyman  was  un- 
daunted, and,  finding  Boston  deaf  to  his  pleadings,  he 
turned  to  neighboring  Brookline  and  Zabdiel  Boylston. 

It  would  seem  that  Boylston  could  not,  as  yet,  have 
been  of  any  special  note;  still  under  forty,  he  must  be 
regarded  merely  as  a  rising  country  doctor ;  by  no  means 
the  old  friend  and  comrade  of  the  distinguished  Mather, 
as  has  frequently  been  stated.  But  he  was  the  man  for  the 
occasion,  and  he  seized  it,  going  about  his  work  in  proper 
conservative  fashion. 

There  was  no  opportunity  for  preliminary  experimenta- 
tion as  in  England,  where  the  Princess  Caroline  persuaded 
the  King  to  hand  over  a  batch  of  convicted  criminals  and 
pauper  children  for  inoculation  tests.^  Indeed,  so  far  as 
one  may  judge  from  the  obscure  records  that  we  have  of 
those  days,  Boylston  was  vigorously  attacked  by  col- 
leagues and  press  so  soon  as  his  purpose  became  known. 

There  were  two  parties  to  the  contention,  as  we  have 
seen,  both  powerful,  and  both  fired  with  the  zeal  of  eager 
conviction.  The  opponents  were  the  doctors,  madly  indig- 
nant at  the  presumption  of  Boylston,  and  they  carried 
their  protest  to  the  civil  authorities  and  the  public  press. 
Very  earnest  men,  mostly,  but  by  no  means  imbued  with 


'  Woodville's  History  of  Inoculation,   1796;    Morris's  History  of 
Inoculation,  1815. 


THE   EIGHTEENTH    CENTURY.  51 

the  spirit  of  science.  Ready  to  go  any  lengths,  they 
alarmed  the  community,  they  petitioned  the  authorities, 
they  aroused  the  mob.  On  the  other  hand,  there  was  Boyl- 
ston,  fighting  single-handed, — fighting  his  own  profes- 
sion; with  a  powerful  backer,  though,  in  the  intrepid 
Mather,  to  whom  controversy,  polemical  or  otherwise,  was 
as  the  breath  of  his  nostrils.  And  Mather's  authority  with 
the  clergy  was  still  great.  We  have  seen  how  certain  of 
the  ministers  at  first  denounced  the  new  practice;  and 
doubtless  they  would  have  continued  their  philippics,  but 
Mather  was  a  prophet  not  to  be  ignored.  So  he  rallied  his 
spiritual  forces  and  led  to  the  fight. 

It  was  truly  an  amazing  spectacle,  giving  pause  to  the 
modern  sceptic:  the  church  applauding  science,  the  fac- 
ulty crying  it  down.  But,  after  all,  to  the  student  of 
ancient  days  there  is  small  cause  for  wonder.  Do  we  not 
know  how  medicine  was  still  a  trade, — the  barber  surgeon 
not  yet  extinct;  how  new  knowledge  was  kept  a  secret 
and  jealously  bought  and  sold;  how  a  conservatism  equal 
to  that  of  the  lawyers  tied  the  doctors  together  in  narrow 
guilds,  dully  guarding  the  secrets  of  antiquity?  Theirs 
was  not  a  profession,  then,  to  attract  the  best  intellects. 
A  hundred  years  later  law,  the  church,  the  army,  the 
navy,  led  it  in  popularity;  it  was  still  but  little  removed 
from  menial  service.  To  it  truth  was  a  vague  and  un- 
meaning term.  Those  were  the  times  of  theories  and 
"  schools"  and  creeds,  the  manacles  of  progress.  Doctors 
were  wont  to  disagree  in  hostile  bands,  and  to  shout  their 
foolish  gibberish  furiously,  with  shaking  of  fists  from  the 
house-tops.  The  laity  took  sides.  Indeed,  there  was  little 
dignity  then;  often  the  profession  was  held  in  slight 
esteem.  That  was  the  common  aspect  of  the  picture  which 
Butler  did  not  so  greatly  caricature.  Some  modest  men, 
working  quietly  and  seriously  for  better  things,  grasping 
feebly  after  facts,  were  the  rare  ones,  as  we  know,  and  of 
such  let  us  believe  was  the  ancient  Boylston. 


52  MEDICINE    IN    AMERICA. 

But  there  was  an  intelligent  clergy,  well  educated  for 
those  days, — far  better  read  than  the  doctors;  impossible 
to  us  now  in  matters  theological,  but  even  then  seeking 
some  freedom;   dreary  to  contemplate,  perhaps,  but  play-' 
ing  a  part  in  their  own  little,  throbbing  world. 

So  the  sight  of  these  two  hostile  camps  of  Mather  and 
of  Douglass  must  not  surprise  us;  quickly  such  sights 
became  rarer.  The  world  was  nearing  some  sort  of  eman- 
cipation. Laymen  take  part  betimes  to-day,  and  choose 
their  "  school,"  but  the  world  of  science  moves  serenely 
on.    Of  all  that  we  must  take  note  in  future  pages. 

The  Douglassites  in  old  Boston  forced  the  attack, 
hoping,  perhaps,  to  frighten  and  rout  the  enemy,  whose 
real  strength  their  leader  knew  too  well.  The  doctors 
called  Boylston  a  rash  and  unscrupulous  quack ;  the  press, 
led  by  Franklin,  shrieked  that  death  under  his  treatment 
was  murder ;  the  mob  chased  him  with  halters  and  bombs ; 
the  selectmen  scolded  him,  and  the  Legislature  brought  in 
a  bill  to  prohibit  the  obnoxious  practice.'^ 

Meantime  Boylston  proceeded  to  open  the  second  scene. 
On  June  2J,  1721,  with  fasting  and  prayer  we  must  sup- 
pose, certainly  with  grave  misgivings,  he  inoculated  his 
thirteen-year-old  son,  not  himself.  It  is  probable  that  he 
had  had  smallpox.  His  own  son,  then,  was  the  first  vic- 
tim; after  that  two  negroes,  his  servants.  Truly  one's 
sympathies  must  go  out  to  those  poor  blacks.  That  first 
patient,  the  doctor's  boy,  with  his  filial  faith,  interests  one 
little ;  but  the  terror  of  those  eighteenth-century  Africans 
one  pictures  as  very  real,  and  wonders  that  their  mental 
state  did  not  obscure  the  test.  Such  thoughts  belong  to 
the  twentieth  century ;  the  records  pass  them  by. 

The  method  used  by  Boylston  was  much  censured  later. 
He  secured  his  virus  by  pricking  with  a  sharp  quill  tooth- 
pick the  pustule  of  an  infected  person.    The  same  instru- 


•  Hutchinson's  History  of  Massachusetts,  vol.  ii. 


THE    EIGHTEENTH    CENTURY.  53 

ment  was  then  used  to  inoculate  the  well.  At  first  the 
actually  sick  were  used  for  material;  later  pus  was  ob- 
tained from  those  already  inoculated.  How  many  other 
diseases  were  conveyed  thus  we  have  no  means  of  know- 
ing.   The  early  patients  soon  recovered  health. 

That  27th  of  June,  1721,  must  be  marked  well  by  us. 
No  earlier  date  in  American  medicine  can  truly  equal  it 
in  importance  and  significance,  and  very  few  dates  since. 
There  is  this  coincidence,  too,  that  some  six  weeks  before, 
in  x\pril,  the  first  inoculation  in  London  was  done  for 
Lady  Mary  Wortley  Montagu  by  Mr.  Maitland,  her  sur- 
geon. The  thought  was  in  the  air.  Such  simultaneous 
advances  are  now  frequently  observed,  and  claims  of  pre- 
cedence are  not  always  edifying. 

Now,  time  and  proof  alone  could  calm  the  raging  of  the 
doctors.  For  time,  then,  Boylston  waited,  while  accumu- 
lating proof.  Two  other  doctors — intrepid  men,  no 
doubt — joined  him:  Roby  in  Cambridge  and  Thompson 
in  Roxbury  performed  their  humble  share.  Family  and 
friends  offered  their  services  to  test  the  novel  cure.  One 
early  volunteer  was  a  Mr.  Walter,  minister  in  Roxbury, 
nephew  of  Mather.  Boylston  inoculated  him,  and  truly 
he  suffered  for  his  pains.  While  at  Mather's,  conva- 
lescing from  the  operation,  the  gentleman  received  a  night 
visit  from  the  mob.  They  stormed  the  house,  insulted  the 
divines,  and  hurled  a  lighted  bomb  into  the  patient's 
room, — lighted  and  bearing  with  it  scurrilous  threats. ^° 
The  fuse  broke  and  caused  no  other  harm.  Thus  did  the 
clergy  suffer  in  the  cause  of  science. 

Boylston  himself  was  hated  most  of  all.  He  could  not 
go  upon  the  street  except  by  stealth,  at  night,  to  visit 
patients.     Lynching  was  threatened  by  the  angry  mob. 


^° "  Cotton  Mather  I  was  once  of  your  meeting,  but  the  cursed  lye 

you  told  of  You  know  who,  made  me  leave  you,  you  Dog. 

And  Damn  you,  I  will  enoculate  you  with  this,  with  a  pox  to  you." 


54  ^lEDICINE    IN   AMERICA. 

They  several  times  attacked  his  house  and  searched  for 
him,  but  missed  his  hiding-place.  They  threw  a  bomb  one 
night,  but,  as  in  Mather's  case,  it  came  to  naught.  Their 
threatening  and  violence  lasted  for  months,  subsiding  only 
with  the  pestilence.  Then  the  doctors  tried  a  final  stroke. 
They  got  Dal  'Honda  to  make  a  deposition  showing  the 
uselessness  and  danger  of  inoculation.  He  stated,  first, 
that  when  in  Cremona,  in  1696,  with  the  French  army, 
soldiers  were  inoculated,  with  a  ver}^-  high  mortality,  de- 
scribing in  gruesome  language  the  post-mortem  findings. 
Second,  that  in  1701  an  officer,  a  patient  of  his  own,  suf- 
fered from  smallpox  some  years  after  a  successful  inocu- 
lation. Third,  that  after  the  battle  of  Almansa,  in  Spain, 
two  soldiers  were  inoculated,  and  that  after  six  weeks 
they  "  went  dead"  with  dreadful  swellings,  as  though  poi- 
soned. With  this  and  other  like  persuasions  the  doctors 
approached  the  Legislature  and  succeeded  in  getting 
through  the  House  of  Representatives  a  bill  prohibiting 
inoculation.  It  went  no  further.  The  Governor's  Council 
held  it  up ;  it  never  became  a  law. 

This  deposition  of  Dal  'Honde  is  often  quoted  to  show 
the  dishonesty  of  the  man,  but  I  doubt  whether  he  was 
worse  than  the  others.  The  facts  he  states  are  probable 
enough,  if  we  admit  his  premises.  The  improbability  lies 
mostly  in  the  dates  as  quoted.  So  that  attempt  fell 
through,  and  the  Franklins  subsided  and  retracted  and 
the  mob  grew  quiet  and  the  law  took  no  further  course. 

These  are  the  results  obtained  by  Boylston  and  Cotton 
Mather,  aided  by  the  faithful  Roby  and  Thompson,  in 
the  first  year  of  their  work.  There  were  two  hundred  and 
eighty-six  persons  inoculated,  of  whom  six  died,  or  one  in 
forty-eight ;  and  of  those  who  died  it  was  said  that  three 
had  contracted  smallpox  before  inoculation.  Within  the 
same  period  five  thousand  seven  hundred  and  fifty-nine 
took  the  disease  in  the  natural  way.  of  whom  eight  hun- 
dred and  forty  died,  or  more  than  one  in  seven. 


THE    EIGHTEENTH    CENTURY.  55 

Whether  or  not  these  figures  speak  for  themselves  to 
the  modern  statistician  may  be  a  question.  At  any  rate, 
even  this  good  showing  was  bettered  subsequently,  it  is 
asserted,  by  improved  methods  of  operating  and  a  regi- 
men of  mercury  as  a  preliminary  course.  But  it  was  a 
great  victory,  and  the  doctors  admitted  their  defeat.  They 
admitted  it  and  they  forgot  it. 

That  naughty  Douglass  was  the  worst  of  all.  He  was 
a  voluminous  and  trenchant  writer,  and  subsequently 
attempted  to  show  that  he  himself  was  the  prophet  of  the 
true  method. 

For  Boylston  the  glory  was  great,  and  in  the  eyes  of 
his  amazed  neighbors  the  reward  beyond  all  dreams.  The 
inoculation  controversy  was  still  raging  in  London,  with 
little  settlement  as  yet  compared  to  what  America  had 
seen.  So  to  London  went  our  good  Boylston,  on  the  invi- 
tation of  Sir  Hans  Sloan,  physician  to  George  L,  to  tell 
his  story  and  demonstrate  his  method.  There  at  first  the 
storm  burst  upon  him  again,  roused  by  one  Wagstaffe 
and  other  such;  but  he  knew  his  ground  and  went  on 
to  certain  triumph.  Four  events  marked  the  visit  for 
him,  though  of  small  concern  to  us  now :  he  kissed  the 
hands  of  a  sympathizing  Royalty,  he  published  an  exten- 
sive and  successful  defence  of  his  case,  he  was  made  a 
member  of  the  Royal  Society, — the  first  native  of  America 
to  be  so  honored, — and  he  was  given  a  thousand  guineas 
by  the  King. 

Then  he  returned  to  Brookline,  a  modest  man  still,  con- 
tent with  home  and  old  enemies  turned  friends.  It  would 
be  pleasant  to  follow  his  career  further  through  those 
remaining  years ;  but,  though  materials  are  not  wanting, 
there  is.  in  truth,  little  to  say.  Thacher  tells  us,  in  one 
place,  that  he  returned  rich  and  retired  from  practice; 
and  in  the  next  sentence  that  he  continued  for  many  years 
active  and  honored  in  his  professional  work  until  old  age, 
when  he  retired  to  his  Brookline  farm,  to  the  raising  of 


56  MEDICINE    IN    AMERICA. 

stock  and  the  breaking  of  young  cattle, — all  of  which  is 
blameless  and  concerns  us  not  at  all.  After  all,  his  real 
work  was  done  early,  and  it  was  a  good  work.  A  forceful, 
courageous  man  he  was,  the  first  American  physician  of 
note,  and  an  honor  to  his  profession. 


CHAPTER    III. 

the  eighteenth  century.     colonial  medicine 
(continued). 

Medical  writing  in  the  America  of  the  eighteenth  cen- 
tury reached  no  great  height,  as  we  may  well  believe. 
Life  was  too  strenuous  and  the  audience  too  small  and 
inaccessible  for  much  of  that  work.  Yet  men  were  begin- 
ning to  see  that  the  interchange  of  ideas  was  necessary  for 
progress,  and  here  and  there  light  began  dimly  to  appear. 

In  spite  of  our  provincialism  and  dependence  on  the 
learning  of  Europe,  we  had  done  something  in  the  devel- 
opment of  inoculation.  Feeble  voices  were  raised  at  first 
to  tell  that  science  was  not  altogether  dead;  then  to  set 
forth  the  ancient  learning  and  to  show  in  what  manner 
and  measure  it  might  be  turned  to  the  new  conditions. 
Mostly  those  early  American  writings  were  brief  disser- 
tations, dealing  with  homely  matters;  the  expression  of 
some  small  personal  trial  and  experience;  sometimes  de- 
scriptive of  the  new  flora  of  the  wilderness,  sometimes 
telling  of  epidemics ;  occasionally  teaching ;  rarely  preach- 
ing;   addressing  the  laity  betimes  as  well  as  the  doctors. 

Those  discourses,  with  few  exceptions,  are  of  little 
interest  to  the  modern  reader.  x\s  curios  they  may  amuse 
the  antiquary,  and  as  pointing  to  the  centres  of  culture 
they  may  occupy  the  student  of  history;  but,  after  all, 
they  impressed  their  times  but  little,  and  Ramsay,  who 
talked  and  wrote  in  the  next  generation,  has  briefly  passed 
them  by. 

But  the  men  who  did  the  work  attract  us  and  tell  their 
story  in  their  busy  lives.  Nearly  sixty  such  writers  ap- 
peared before  the  Revolution;    their  essays  cover  near  a 

57 


58  MEDICINE    IN   AMERICA. 

hundred  themes.^  Those  whose  work  has  reached  us  were 
educated  men ;  natives  of  the  British  Isles,  many  of  them ; 
some  few  born  in  America. 

It  is  instructive  to  see  how,  even  in  those  days,  the 
American  spirit  and  atmosphere  attracted  the  foreigners, 
who,  almost  without  exception,  promptly  became  stanch 
enthusiasts  for  the  new  country. 

Of  these  strangers  who  came  to  live  among  us  the  most 
notable,  as  a  writer,  administrator,  and  Nestor  at  the  last, 
was  Cadwallader  Colden.  This  distinguished  man  was 
born  in  Scotland,  at  Dunse,  in  1688, — very  long  ago  his- 
torically :  the  year  of  the  English  Revolution  of  William 
and  Mary, — and  lived  through  the  greater  part  of  the 
eighteenth  century.  Surviving  the  Declaration  of  Inde- 
pendence in  his  adopted  country,  he  died  on  September 
28,  1776.  Throughout  his  long  and  useful  life  he  was 
constantly  prominent  in  the  midst  of  men  and  affairs; 
more  so  than  any  scientist  among  us,  if  we  except  his 
friend  Franklin.  He  was  a  public  man,  and  the  tale  of 
his  life  involves  us  with  questions  of  the  first  importance. 

In  1705,  at  the  age  of  seventeen,  Colden  was  graduated 
in  arts  from  the  University  of  Edinburgh ;  then  he  studied 
medicine,  and  received  the  M.D.  when  twenty  years  old. 

The  New  World  had  always  strongly  attracted  him, 
especially  those  parts  recently  acquired  by  William  Penn. 
The  act  of  union  between  England  and  Scotland  had  gone 
into  effect  in  1707,  with  a  resulting  considerable  exodus 
from  the  latter  country  for  several  subsequent  years. 
Colden  felt  the  impulse  with  many  others.  Well  con- 
nected and  educated,  vigorous  and  ambitious  in  an  unusual 
degree,  he  looked  for  a  life  of  greater  activity  and  promise 
than  could  be  found  at  home,  and  in  17 10  emigrated  to 
the  new  city  of  Philadelphia. 

This  was  the  year  of  the  founding  of  the  famous  South 


^  F.  R.  Packard,  p.  429  ct  seq. 


THE    EIGHTEENTH    CENTURY.  59 

Sea  Company — the  greatest  bubble  in  history — and  the 
last  year  of  Marlborough's  wars.  Europe  was  seething 
with  various  activities  and  enterprises.  Never  had  the 
instinct  for  travel  and  migration  been  stronger ;  so  Colden 
found  himself  but  one  of  many  in  his  journey  to  the 
New  World. 

That  eighteenth-century  expansion  was  a  very  different 
thing  from  the  adventurous  voyaging  of  a  hundred  years 
before.  In  the  seventeenth  century  men  had  gone  to  fight 
and  v/ander,  seeking  gold  and  other  booty;  Colden  and 
his  like  were  of  another  kidney,  and  seriously  started  forth 
as  colonists  to  settle  and  upbuild. 

So  Colden  settled  in  Philadelphia  and  began  the  prac- 
tice of  his  profession ;  zealous,  we  are  told,  full  of  enthu- 
siasm, very  different  in  temper  from  that  fellow-country- 
man of  his,  William  Douglass,  who  a  few  years  later  went 
scoffing  by  to  Boston.  Colden  was  still  young  and  not 
poor.  He  soon  felt  the  need  of  greater  experience  and  a 
knowledge  of  London  ways.  With  the  determination  to 
make  good  his  lack,  he  continued  on  for  five  years,  prac- 
tising, studying,  and  writing;    then  to  London. 

The  one  note  of  interest  in  that  visit  was  the  publication 
of  his  first  medical  paper,  written  in  Philadelphia.  He 
fell  in  with  the  distinguished  Edmund  Halley,  whose 
protege  he  became  in  some  sort;  and  to  Halley  he  con- 
fided a  paper  on  Animal  Secretion  which  that  eminent 
man  read  before  the  Royal  Society. 

Then  came  courtship  and  marriage.  The  lady  was  a 
Miss  Christie,  of  good  Scotch  family.  In  1716  the  young 
people  returned  to  America,  and  two  years  later  took  up 
a  residence  permanently  in  New  York  City. 

It  is  an  interesting  fact  that,  though  a  physician,  and 
in  his  day  distinguished  as  a  scientist,  Colden  became 
known  to  history  rather  as  a  statesman  and  public-spirited 
citizen. 

Just  how  long  he  practised  medicine  after  going  to 


6o  MEDICINE    IN   AMERICA. 

New  York  in  171 8  is  somewhat  uncertain,  but  it  could 
not  have  been  long;  he  soon  left  that  pursuit  to  turn  to 
the  study  of  science  and  politics. 

His  public  career  need  not  concern  us.  It  was  long  and 
varied.  He  held  many  offices  and  served  many  years. 
Though  known  and  referred  to  by  contemporaries  as 
"  Governor  Golden,"  he  was  actually  Lieutenant-Governor 
only,  after  having  been  Surveyor-General  of  the  province, 
Master  in  Chancery,  and  a  member  of  the  Governor's 
Council.  To  that  last  office  of  Lieutenant-Governor  he 
was  appointed  by  the  Crown  in  1761,  fifteen  years  before 
his  death,  and  during  his  incumbency  the  functions  of 
Governor  repeatedly  fell  to  him  owing  to  the  deaths  or 
absences  of  several  governors. 

In  the  opening  year  of  the  Revolution,  after  the  return 
of  Governor  Tryon,  when  he  had  himself  reached  his 
eighty-eighth  year,  he  withdrew  from  active  political  life 
and  retired  to  an  estate  on  Long  Island,  where  he  died 
on  September  28,  1776. 

This  brief  sketch  shows  us,  in  some  measure,  what 
manner  of  man  he  was  in  his  public  activities.  Probably, 
with  the  exception  of  Rush,  no  American  ph}^sician  has 
ever  taken  so  vigorous,  honorable,  and  influential  a  part 
in  the  political  life  of  his  community,  and  certainly  few 
among  us  have  ever  acquired  a  more  substantial  appre- 
ciation from  the  public. 

Colden's  life  previous  to  his  assuming  the  lieutenant- 
governorship  was  devoted  largely  to  the  study  of  science 
and  the  conditions  of  the  new  country  in  which  his  lot  was 
cast.  Incidentally  and  supplementary  to  this  he  frequently 
held  public  office.  No  one  of  his  works  has  proved  of 
conspicuous  or  permanent  value — few  works  of  men  are 
that;  but  the  presence  in  the  young  country  of  a  man 
highly  cultivated,  candid,  well  acquainted,  eager  and 
thorough  in  science  was  a  stimulus  and  an  example  which 
bore  fruit  long  after  he  himself  had  ceased  from  his  labors. 


THE   EIGHTEENTH    CENTURY.  6i 

In  1720  Golden  had  abandoned  the  practice  of  his  pro- 
fession, being  appointed  Surveyor-General  of  the  province 
of  New  York;  and  in  that  year  he  published  his  first 
brief  paper  in  this  country :  an  "  Account  of  the  Climate 
and  Diseases  of  New  York."  It  is  very  interesting.  As 
Beck  observes,  perhaps  his  most  notable  remark  is  that 
in  regard  to  consumption  : 

"  The  air  of  the  country  being  almost  always  clear, 
and  its  spring  strong,  we  have  few  consumptives,  or  dis- 
eases of  the  lungs.  People  inclined  to  be  consumptive  in 
England  are  often  perfectly  cured  by  our  fine  air,  but  if 
there  be  ulcers  formed,  they  die  in  a  little  time.  .  .  .  The 
climate  grows  every  day  better  as  the  country  is  cleared 
of  the  woods :  and  more  healthy,  as  all  the  people  that 
have  long  lived  here  testify.  ...  I  therefore  doubt  not 
but  it  will  in  time  become  one  of  the  most  agreeable  and 
healthy  climates  on  the  face  of  the  earth.  As  it  is  at  pres- 
ent, I  prefer  it  to  the  climate  of  England,  and  I  believe 
most  people  that  have  lived  any  considerable  time  here, 
and  returned  to  England,  will  confirm  this." 

This  immunity  from  consumption  enjoyed  by  New 
York  was  of  very  brief  duration,  for  the  editors  of  the 
Medical  Register,  two  generations  later,  exclaim  at  the 
changed  conditions  even  in  their  time. 

The  paper  on  climate  is  made  to  serve  by  the  editors 
of  the  Register  as  a  sort  of  introduction  to  a  much  more 
famous  and  valuable  paper  by  Golden  on  "  The  Fever 
which  prevailed  in  the  City  of  New  York  in  1 741-2." 
This  careful  publication  dealt  largely  with  public  hygiene. 
The  wise  of  our  day  would  call  it  timely.  It  is  an  elabo- 
rate review  of  soil,  water,  drainage,  and  fresh  air,  and 
came  to  the  community  at  the  right  time.  The  authorities 
of  the  day  appreciated  its  suggestions,  and  proceeded  to 
establish  a  plan  of  public  drainage  which  in  time  proved 
of  the  greatest  value. 

Then  there  is  that  paper  of  his  "  On  the  Virtues  of  the 


62  MEDICINE    IN   AMERICA. 

Great  Water  Dock," — a  striking  title,  and  one  wonders 
why  it  recurs  continually  in  memoirs  coupled  with  Col- 
den's  name.  One  fain  would  ask.  What  are  those  won- 
drous virtues?  It  was  the  paper,  not  the  poor  Rumex 
aquaticiis,  that  we  must  marvel  at ;  and  because  it  had  the 
good  fortune  to  introduce  the  young  American  to  Lin- 
naeus, and  so  to  open  a  long  and  pleasant  correspondence. 
Sixty  years  ago  Professor  Asa  Gray  collected  the  corre- 
spondence of  these  two  men  and  other  Colden  letters, — a 
very  human  production. 

Somewhere  about  the  year  1730  Colden  acquired  an 
estate  near  Newburg  on  the  Hudson,  and  named  it  Col- 
denham.  There  he  lived  mostly  for  many  years,  and  the 
place  became  famous  in  that  century  as  a  home  of  science 
and  letters  and  a  centre  of  kindly  hospitality.  Coldenham 
and  coldenia  in  some  fashion  perpetuate  the  man's  name ; 
the  latter  a  plant  of  the  tetrandrous  class,  first  described 
by  Colden's  daughter,  and  so  named  in  her  honor  by  her 
father's  friend  Linnaeus. 

Another  paper  by  Colden  was  a  letter  to  Dr.  Fothergill, 
of  London,  giving  an  account  of  the  throat  distemper 
which  had  prevailed  in  New  Hampshire  in  1735  and 
spread  later  through  New  England,  New  York,  and 
finally  throughout  the  colonies.  This  had  been  described 
by  the  nimble-minded  Douglass  years  before,  and  was 
undoubtedly  that  malignant  disease  which  came  later  to 
be  known  as  diphtheria. 

In  1 741  Mr.  Collinson,  of  London,  wrote  to  Colden, 
"  I  also  sent  Mr.  Grayham  your  History  of  the  Five 
Indian  Nations:  he  was  mightily  pleased  with  it  and 
hoped  you  would  oblige  the  world  with  the  second  part." 
Indeed,  that  History  became  the  best  known  and  most 
popular  of  Colden's  writings,  and  Mr.  Grayham  echoed 
but  feebly  the  opinion  of  American  readers. 

There  were  many  other  papers  on  medical  subjects, 
all  brief,  discriminating,  and  valuable  in  their  time;   but 


THE    EIGHTEENTH    CENTURY.  63 

most  of  his  writing  was  on  botany  at  first  and  later  on 
physics. 

With  Benjamin  Franklin  he  corresponded  constantly. 
They  were  intimates,  with  similar  tastes,  and  discussed 
electricity,  gravitation,  philosophy,  and  a  wide  range  of 
scientific  subjects.  Stereotyping  as  subsequently  intro- 
duced in  Paris  was  an  invention  of  Colden,  and  was 
appropriated  and  exploited  without  recognition  by  an  in- 
genious Frenchman  in  Napoleon's  time.  It  was  Colden, 
too,  who  first  suggested  to  Franklin  an  American  Philo- 
sophical Society,  and  he  was  one  of  the  original  members. 

Indeed,  his  activities  were  constant  and  multifold.  As 
Packard  notes,  one  among  the  efforts  of  his  young  pro- 
fessional life  in  Philadelphia  was  to  have  established  a 
course  of  "  public  physical  lectures,"  and  to  bring  about 
that  the  bodies  of  the  dead  should  be  inspected  by  a  prop- 
erly accredited  physician.  The  authorities  failed  to  ap- 
prove these  plans,  but  the  plans  must  be  remembered  as 
evidence  that  nearly  two  hundred  years  ago  the  subject 
of  medical  study  and  instruction  was  already  in  mind. 

No  American  physician  of  the  colonial  time  has  left 
more  copious  literary  remains.  In  addition  to  the  works 
already  mentioned,  a  writer  gives  a  long  list  (in  the 
Medical  and  Philosophical  Register),  including  medical 
essays  and  observations,  historical  papers,  dissertations 
on  the  subjects  of  botany,  electricity,  and  general  litera- 
ture, and  a  great  mass  of  correspondence  with  foreign 
savants  and  with  such  Americans  as  Franklin,  Garden, 
Douglass,  Bartram,  Whytte,  Bard,  and  Alexander. 
Indeed,  the  correspondence  is  very  full  and  complete  from 
the  year  1710  to  1776,  and  has  proved  of  extreme  value 
to  the  student  of  those  times. 

His  biographers  and  admirers  are  abundantly  laudatory 
of  the  man  and  his  works.  Doubtless  he  was  a  remarkable 
person  in  his  day  and  generation,  to  be  classed  next  to 
Franklin  in  many  things;    and  had  it  not  been  for  the 


64  MEDICINE    IN   AMERICA. 

stormy  days  of  the  Revolution  which  obscured  his  closing 
years,  and  the  rising  of  many  truly  great  figures  on  the 
national  stage,  Colden,  the  statesman  and  man  of  science, 
would  have  come  down  even  to  our  own  days  a  very  real 
and  commanding  personality. 

Bo3dston,  Douglass,  and  Colden  were  the  three  con- 
spicuous physicians  of  their  generation,  but  in  many  parts 
of  the  country  others  of  some  note  were  beginning  to 
appear,  and  of  them  we  must  say  a  word  before  turning 
to  the  brilliant  company  of  young  men  who  rose  up  in 
Philadelphia  and  New  York  during  the  later  colonial  days. 

Many  of  the  notable  men  of  the  first  half  of  that  century 
were  British  born,  although  there  were  some  exceptions, 
and  of  these  last  the  most  conspicuous  was  Thomas  Cad- 
wallader,  of  Philadelphia.  Here  was  a  case  in  which  a 
man's  true  claims  on  posterity  are  not  entirely  obvious. 
Some  communities  more  than  others  hold  a  halo  behind 
the  heads  of  their  great  men,  and  so,  at  times,  modest 
merit  finds  more  than  modest  recognition. 

Now,  Cadwallader  was  one  of  a  well-known  family  and 
the  son  of  a  prominent  physician.  He  was  by  no  means 
lacking  in  ability.  For  his  place  and  generation  he  was 
unusually  well  educated,  finishing  his  studies  under  com- 
petent men  in  London,  the  most  notable  of  whom  was 
Cheselden. 

Perhaps  the  fame  of  Cadwallader  rests  mainly  on  his 
broad  humanity,  which,  with  a  background  of  sound 
common  sense,  unusual  ability  and  learning,  and  constant 
industry,  made  him  the  most  conspicuously  successful 
practitioner  of  his  time.  Indeed,  he  represented  the  very 
best  in  what  we  have  come  to  call  the  "  old-fashioned 
family  doctor,"  a  type  too  rarely  seen  among  us  in  these 
latter  days. 

And  he  was  by  no  means  without  originality.  On  his 
return  from  London,  a  young  man,  he  established,  by 
request,  a  class  in  practical   dissections,   demonstrating 


THE    EIGHTEENTH    CENTURY.  65 

anatomy  as  well  as  performing  autopsies  for  his  less  well- 
informed  colleagues.  This  service  was  abundantly  praised 
and  appreciated  by  the  men  of  his  time. 

Some  medical  writing  he  did  also.  The  best  known  of 
his  productions,  "  An  Essay  on  the  Iliac  Passion,"  became 
a  classic,  and  was  for  years  quoted  by  Rush  and  other 
teachers  as  a  sound  and  luminous  exposition.  That  title 
has  an  unfamiliar  sound  in  modern  ears,  but  one  learns 
that  the  complaint  was  common  in  former  days,  being 
that  condition  now  called  ileits.  A  perusal  of  the  article 
suggests,  however,  the  probability  that  many  of  the  cases 
would  now  fall  under  the  head  of  appendicitis.  This  was 
one  of  the  earliest  of  American  medical  publications. 

With  the  other  intelligent  physicians  of  his  time,  Cad- 
wallader  appreciated  the  value  of  a  sound  medical  educa- 
tion, and  was  active  among  those  who  forwarded  the 
establishment  of  a  medical  school. 

Here  is  an  anecdote  of  him ;  rather  pleasant,  though  it 
reflects  on  the  wisdom  and  justice  of  colonial  courts. 
Good  Dr.  Thacher  rolls  it  under  his  tongue  as  a  morsel 
to  be  cherished. 

There  lived  in  Cadwallader's  neighborhood  a  "  provin- 
cial officer"  of  some  sort,  who  became  the  victim,  evi- 
dently, as  we  get  the  tale,  of  a  mental  disorder  with 
suicidal  and  homicidal  tendencies.  His  delusion  led  him 
to  the  conviction  that  he  could  go  out  of  the  world  only 
through  public  execution  as  a  murderer.  Accordingly  he 
sallied  forth  one  morning,  fitsil  in  hand,  with  intent  to 
kill.  The  first  person  he  met  was  a  pretty  girl,  but  her 
face  saved  her.  Then  came  along  Dr.  Cadwallader,  kindly 
and  affable,  with  his  "  Good-morning,  sir;  what  sport?" 
and  the  courtesy  saved  him.  As  the  man  said  later,  he 
was  so  struck  with  the  pleasing  manner  and  address  that 
he  had  no  heart  to  kill  him.  But  the  sportsman  went  on. 
Soon  he  came  to  a  tavern,  where  he  turned  in,  encoun- 
tered a  Mr.  Scull,  and  shot  him  dead.     The  tale  is  not 

5 


66  MEDICINE    IN    AMERICA. 

without  its  humor,  and  leaves  one  to  conclude  that  poor 
Mr.  Scull  was  neither  beautiful  nor  pleasing.  At  any 
rate,  there  is  our  lesson,  as  the  historian  says;  and  the 
poor  demented  officer  was  promptly  apprehended,  tried, 
and  hung  in  sight  of  the  tavern  where  he  had  murdered 
the  unattractive  Mr.  Scull. 

When  all  is  said,  then,  Cadwallader's  claims  on  us  rest 
mainly  upon  those  qualities  of  heart  and  head  of  which 
we  know,  and  he  must  be  remembered,  we  are  told,  as  a 
shining  example  of  the  best  practice  of  his  time. 

It  has  been  asserted  and  frequently  repeated  by  writers 
that  there  was  a  time  in  the  first  three-quarters  of  the 
eighteenth  century  when  science  was  more  popular  and 
more  successfully  cultivated  in  the  South  than  in  the 
Middle  colonies  and  New  England.  This  is  interesting, 
if  true,  and  rests  on  the  assertion  of  David  Ramsay,  him- 
self a  South  Carolinian;  but  later  studies  lead  one  to 
suspect  that  Ramsay's  acquaintance  with  early  American 
medical  writings  was  not  as  extensive  as  he  might  have 
made  it.  However  that  may  be,  the  South  did  produce  a 
goodly  number  of  able  scientific  writers  and  practitioners 
in  the  pre-Revolutionary  days;  and  of  all  the  Southern 
towns  conspicuous  for  medical  talent,  Charleston  stood 
first. 

Ramsay,  in  his  well-known  article,  which  is  copied  ver- 
batim by  all  of  our  medical  historians  of  those  times, 
states  that  "  In  that  early  period  of  American  Medical 
History,  which  was  before  Dr.  Rush  began  his  brilliant 
career  as  an  author,  there  were  more  experiments  made, 
more  observations  recorded,  and  more  medical  writings 
ushered  into  public  view  by  the  physicians  of  Charleston 
than  of  any  other  part  of  the  American  continent." 

Those  decades  in  the  middle  of  the  eighteenth  century 
were  very  cheerful  and  prosperous  times  in  South  Caro- 
lina. It  was  one  of  the  newest  colonies,  being  but  thirty- 
eight  years  old  when  Colden  came  to  settle  in  New  York 


THE    EIGHTEENTH    CENTURY.  67 

in  1 718,  and  when  Douglass  and  Mather  hegan  their 
sparring  in  the  Massachusetts  Bay  Colony.  Turmoil 
marked  the  first  half-century  of  the  life  of  the  Carolinas: 
Indian  fights,  contests  with  the  proprietors  and  governors, 
and  alarms  because  of  Spanish  invasions, — conditions  not 
very  favorable  to  the  success  of  studious  scientific  pursuits. 
Almost  from  the  first,  however,  the  institution  of  slavery 
had  favored  a  feudal  condition  of  affairs  and  had  served 
to  evolve  and  nourish  a  large  class  of  landed  proprietors, 
who  gradually  came  to  accumulate  wealth  of  a  certain 
sort  and  to  develop  a  distinct  hereditary  gentry  class. 
That  was  before  the  era  of  King  Cotton.  The  planters 
had  discovered  a  staple  in  the  cultivation  of  indigo,  which, 
with  rice,  became  the  great  product  of  the  colony  and  in 
time  the  source  of  wealth.  Property  increased  rapidly  in 
value,  especially  after  the  conclusion  of  peace  with  the 
Indians,  and  the  great  planters  began  to  rival  in  luxury 
and  comfort  the  sugar  growers  of  the  West  Indies. 

So  it  came  about  towards  the  middle  of  the  century 
that  Charleston,  the  port  of  the  region  and  the  centre  of 
its  wealth,  society,  and  commercial  life,  began  to  be  heard 
of  in  foreign  parts  and  to  attract  ambitious  young  pro- 
fessional men  from  the  old  country.  The  youth  of  the 
land,  too,  began  to  look  to  Europe  for  education  and 
travel :  elder  sons  to  an  experience  of  the  life  of  courts, 
the  daughters  of  the  land  to  the  perfecting  of  their  accom- 
plishments, and  ambitious  younger  sons  to  University 
studies  and  the  learned  professions. 

The  strides  made  by  the  youthful  colony  were  sur- 
prising indeed ;  so  we  must  not  wonder  at  the  fact  that, 
among  other  precocities,  Charleston  became  in  some 
degree  famous  as  a  centre  of  learning  and  of  culture. 

While  the  Eastern  and  Middle  colonies  were  producing 
their  numerous  practitioners  and  a  few  men  better  known 
to  us,  South  Carolina  was  honored  by  the  lives  of  a  group 
of  five  men  who  deserve  especial  notice :  Chalmers,  Lining, 


68  MEDICINE    IN   AMERICA. 

Garden,  Moultrie,  and  Bull.  Not  that  their  contribu- 
tions to  science  were  of  great  permanent  value,  but  because 
they  were  men  of  sound  understanding-  and  unusual  culti- 
vation, who  led  long  and  arduous  lives  in  our  midst,  who 
taught  from  the  very  first,  by  precept  and  example,  the 
value  of  exact  observation  and  research,  and,  more  than 
others,  seem  to  have  appreciated  that  progress  is  attained 
not  only  by  the  brilliant  discoveries  of  the  few  but  by  the 
obscure  toil  of  the  many. 

Though  the  five  were  very  distinct  individuals,  one 
cannot  but  think  of  them  as  a  group,  always  classed 
together  and  forming  a  complex,  like  their  successors  of 
other  places  and  eras,  as  we  shall  see.  Bull  was  an  Amer- 
ican; the  other  four  were  Scotchmen,  as  their  names 
imply.  Indeed,  the  Scotch  blood  of  much  of  South  Caro- 
lina was  its  boast  then  as  it  has  not  ceased  to  be  in  later 
times. 

Perhaps,  of  all  the  group,  William  Bull  is  the  least 
conspicuous ;  but  we  remember  this  of  him,  that  he  was 
"  the  first  white  person  born  in  South  Carolina,"  ^  and 
was  the  first  native  Carolinian  to  receive  the  doctor's 
degree.  He  was  a  pupil  of  Boerhaave,  and  was  grad- 
uated from  the  University  of  Leyden  in  1734.  We  hear 
his  European  friend  and  contemporary,  Van  Swieten, 
speaking  of  him  as  "  the  learned  Dr.  Bull."  Later  he 
returned  to  Charleston  and  took  up  the  practice  of  his 
profession. 

Like  Colden,  of  New  York,  he  was  interested  in  many 
things.  His  father  was  at  one  time  Lieutenant-Governor 
of  the  colony,  and  he  himself  was  drawn  to  public  affairs; 
so  he  gradually  abandoned  his  practice,  as  did  Colden. 
We  find  him  drifting  more  and  more  into  politics,  being 


"  Tliaclicr.  Tliis  is  remarkable,  if  true.  The  Carolinas  were  set- 
tled in  1680;  Bull  was  horn  in  1709;  the  colony  was  divided  into 
North  and  South  Carolina  in  1719. 


THE    EIGHTEENTH    CENTURY.  69 

a  member  of  the  Governor's  Council,  Speaker  of  the 
House  of  Representatives,  and  in  1764  Lieutenant-Gov- 
ernor.   This  office  he  held  for  many  years. 

Like  so  many  of  the  older  generation,  he  was  a  Tory. 
He  could  not  continue  in  his  native  State  after  the  Revo- 
lution, but  sailed  in  1782  v^ith  the  evacuating  British 
garrison,  and  passed  his  remaining  years  in  London,  where 
he  died  in  1791.  So  much  for  that  ancient  American- 
born  Bull;  vigorous,  scholarly,  potent  for  many  years, 
but  futile  at  the  last. 

The  four  Scotchmen — Chalmers,  Garden,  Lining,  and 
Moultrie — who  came  to  South  Carolina  in  the  first  half 
of  the  eighteenth  century  were  certainly  of  a  type  which 
would  have  been  unusual  even  in  Philadelphia  and  New 
York.  The  detail  of  their  lives  is  profitless  here,  but  some 
few  words  may  be  said  to  fix  the  men  in  the  reader's 
memory. 

John  Lining  was  the  eldest  (1708- 1760).  He  was 
perhaps  the  earliest  American  physiologist.  His  fame  in 
this  branch  rested  on  an  elaborate  series  of  experiments 
in  metabolism,  the  results  of  which  were  published  in  the 
"Transactions  of  the  Royal  Society"  for  1743.  For  a 
year  he  had  made  careful  records  of  his  daily  weight,  of 
food  eaten,  and  of  his  excretions ;  all  this  while  occupied 
with  a  busy  and  exacting  practice.  The  results  obtained 
from  his  carefully  compiled  tables  were  long  a  standard 
for  students.  Ten  years  later  he  published  an  interesting 
and  exhaustive  "  Description  of  American  Yellow  Fever," 
the  first  American  account  of  that  disease. 

Almost  as  much  as  the  smallpox  of  the  seventeenth  cen- 
tury, yellow  fever  was  the  scourge  and  terror  of  the 
eighteenth.  As  we  well  know,  it  was  endemic  in  the 
West  Indies,  and  from  there  frequent  epidemics  swept 
through  the  seaports  of  North  America.  From  Boston 
to  Savannah  every  physician  was  alert  to  recognize  it, 
and  its  study  was  the  frequent  occupation  of  many  gen- 


70 


MEDICINE    IN   AMERICA. 


erations.  Lining  it  was  who  most  persistently  advertised 
the  theory  of  immunity  after  attack,  and  to  him  more 
than  to  any  other  one  man  the  general  recognition  of  that 
fact  became  due.  His  descriptions  are  graphic  for  us 
to-day.  These  Scotchmen,  with  their  knowledge  of  the 
world,  wider  than  that  of  most  native  Americans  of  the 
day,  were  in  a  better  position  for  study  and  correspond- 
ence than  their  American  colleagues,  so  that  we  are  wont 
to  find  them  in  closer  touch  with  the  advances  of  the 
science  of  the  time.  Lining  not  only  practised  in  his  little 
community,  but  preached  to  a  larger  audience,  and  we 
find  him  writing  to  well-known  men  in  London,  as  well 
as  to  Franklin,  Colden,  and  other  such  at  home.  The 
records  call  him  a  distinguished  American  philosopher, 
and  doubtless  he  deserves  the  description;  at  least  it  is 
Avell  to  place  him  as  such  in  the  little  Charleston  group. 

John  Moultrie  \vas  the  second  of  these  well-known 
Scotchmen ;  to  be  distinguished  always  from  his  son  John, 
with  whom  he  is  confused  by  Bard  in  his  excellent  mono- 
graph. The  younger  Moultrie  was  a  doctor  also  and  a 
politician,  but  less  famous  than  his  father.  The  elder 
Moultrie  deserves  no  notice  as  a  writer  or  student.  His 
fame  is  rather  of  the  type  of  old  Deacon  Fuller  and  the 
Philadelphia  Cadwallader.  He  had  a  rare  genius  for 
practice,  and  was  adored  by  the  laity,  especially  by  the 
women.  All  the  writers  praise  him,  and  follow  Ramsay 
in  telling  this  of  him,  that  "  his  death  was  regarded  as  a 
great  public  calamity.  Several  of  the  ladies  of  Charles- 
ton bedewed  his  grave  with  tears  and  went  into  mourn- 
ing on  the  occasion." 

He  must  indeed  have  been  a  remarkable  old  man,  for  al- 
though he  died  two  years  before  Bunker  Hill,  after  forty 
years  of  phenomenal  success,  he  was  recalled  with  regret 
and  affection  until  well  into  the  next  century.  He  seems 
to  have  been  a  jovial  soul ;  for  patients  in  peril  would 
send  for  him,  even  on  the  festive  evening  of  St.  Andrew's 


THE    EIGHTEENTH    CENTURY.  71 

Day,  preferring  his  services  to  those  o£  any  other  profes- 
sional man,  though  sober.  So  great  was  his  practice  in 
cases  of  childbirth,  and  so  dependent  upon  him  had  the 
women  of  Charleston  become,  that  after  his  death  many 
of  them  despaired  of  their  lives  as  their  time  approached, 
and  the  mortality  from  this  cause  was  uncommonly  great 
during  the  succeeding  year.  But  the  man  died  and  the 
world  went  on,  somewhat  poorer  and  sadder,  indeed, 
mindful  of  those  tears  which  had  been  shed. 

Of  far  more  concern  to  us,  however,  than  the  excellent 
Lining  or  the  jovial  and  lamented  Moultrie  were  those 
other  two  Scotchmen,  Chalmers  and  Garden. 

Lionel  Chalmers  was  born  in  Scotland  in  171 5,  and 
after  being  graduated  at  Edinburgh,  came  to  Charleston 
about  1745.  A  friend  and  contemporary  of  Cullen  and 
William  Hunter,  he  began  life  with  the  same  impulses 
and  ambitions  as  those  distinguished  men,  and  carried  his 
energies  with  him  across  the  sea.  Fortunately  for  his 
fame,  though  unfortunately,  perhaps,  for  his  pocket, 
Chalmers  was  also  a  contemporary  and  fellow-townsman 
of  the  popular  Moultrie.  No  competition  in  practice  could 
succeed  against  such  a  man;  so  that  Chalmers,  although 
successful  to  the  extent  of  making  a  decent  living,  found 
abundant  time  for  original  research  and  for  writing.  His 
writing  was  good;  his  English  terse  and  vigorous;  his 
descriptions  clean-cut  and  lucid.  Few  compositions  of 
that  day  are  pleasanter  reading  than  his  "Account  of  the 
Weather  and  Diseases  of  South  Carolina,"  published  in 
1776.  And  he  is  convincing,  too.  In  this  he  differs 
widely  from  that  other  fellow-countryman  of  his,  William 
Douglass,  in  his  famous  "  Summary,  Historical  and  Po- 
litical." That  book  of  Douglass  is  ingenious  and  most 
amusing,  but  so  full  of  exaggeration  and  malice  as  con- 
stantly to  refute  itself,  leaving  one  to  wish  that  the  author, 
like  Dean  Swift,  might  have  recognized  fiction  as  his 
proper   forte.      Douglass   did   not   lack   humor,    though. 


72 


MEDICINE    IN   AMERICA. 


which  makes  him  bearable;  while  Chalmers  took  himself 
as  seriously  as  any  other  Scotchman.  But  for  all  that,  he 
is  interesting,  and  his  description  of  Charleston,  written 
one  hundred  and  thirty  years  ago,  is  well  worth  reading. 

There  were  about  five  thousand  white  folk  there,  he 
tells  us,  with  a  death-rate  of  about  twenty-seven  to  the 
thousand.  The  negroes  were  more  numerous  than  the 
whites  and  quite  as  susceptible  as  the  former  to  all  sorts 
of  diseases,  excepting  yellow  fever  and  gout.  In  both 
races  the  birth-rate  exceeded  the  death-rate  in  those 
days. 

Then  he  goes  on  to  describe  the  white  natives  of  the 
region : 

"  The  natives,  for  the  most  part,  rise  above  the  mid- 
dling stature  and  they  attain  their  full  height  sooner  than 
the  people  usually  do  in  colder  climates.  In  general  they 
are  of  a  slender  make  with  a  pale  complexion.  They  are 
forward  in  genius  and  thought,  capable  of  receiving  in- 
struction earlier  than  children  in  Britain  commonly  are. 
With  respect  to  their  character,  they  are  hospitable,  and 
of  a  mild  temper,  which  is  yet  not  without  a  quick  sensi- 
bility of  any  designed  affront;  but  their  passions  soon 
subside.  Few  live  sixty  years,  and  the  hoary  appear- 
ances of  old  age  often  show  themselves  at  the  age  of 
thirty  years.  .  .  .  The  women  are  in  full  bloom  between 
their  sixteenth  and  twenty-fifth  years,  and  they  very  gen- 
erally are  well  featured  and  genteel  in  person." 

The  tale  goes  on  with  a  pleasant  account  of  the  climate 
of  the  country,  describing  vividly  the  commonly  prevailing 
fogs,  hurricanes,  thunder-storms,  and  other  phenomena, 
the  character  of  which  must  have  changed  greatly  since 
that  time.  As  to  diseases,  gout  and  its  accompaniments 
seemed  to  him  the  most  striking;  so  that,  reading  his 
pages,  one  may  almost  fancy  whole  populations  limping 
feebly  from  the  cradle  to  the  grave.  The  subject  of  the 
treatment  of  various  disorders  occupies  much  space.   The 


THE   EIGHTEENTH    CENTURY.  73 

writer  never  halts,  and  the  book  may  be  opened  anywhere 
to  some  striking  and  thoughtful  description. 

Besides  this  work,  which  must  have  occupied  years  of 
study  and  careful  arrangement,  Chalmers  had  already 
made  himself  widely  known  as  an  author.  As  early  as 
1754  he  had  published  an  article  on  "  Opisthotonos  and 
Tetanus"  in  the  Medical  Observations  and  Inquiries  of 
London,  and  in  1768  he  published  "  An  Essay  on  Fevers." 
This  essay  interests  the  student  of  ancient  theories  be- 
cause it  shows  the  influence  of  Hoffmann's  teaching  and 
anticipates  the  ideas  of  Cullen.  To  Hoffmann  was  due 
the  overthrow  of  the  old  humoral  pathology  of  Galen  and 
recognition  of  the  fact  that  the  seats  of  disease  did  not 
lie  necessarily  in  the  blood  but  in  the  various  organs; 
hence  the  term  "  Solidism,"  later  elaborated  by  William 
Cullen.  To  that  vigorous  Scotchman  was  due  the  teach- 
ing of  what  Ramsay  calls  "  the  modern  spasmodic  theory 
of  fevers." 

This  same  conception  of  pathology  which  made  Cullen 
famous  throughout  Europe  was  anticipated  by  his  friend 
Chalmers,  who  believed  the  immediate  cause  of  fever  to 
be  a  "  spasmodic  contraction  of  the  arteries  and  other 
muscular  membranes."  Whatever  might  give  pain  or 
stimulate  the  nerves  so  as  to  cause  them  to  excite  such 
constrictions,  he  taught,  might  bring  on  fever. 

The  essay  is  an  extremely  ingenious  one,  and  the  argu- 
ments are  supported  by  a  mass  of  learning  and  quotation. 
Doubtless,  if  the  author  had  been  more  advantageously 
placed  for  teaching  and  expounding  he  would  have  ob- 
tained a  fame  equal  to  that  of  Cullen,  whose  writing  is 
so  closely  in  accord  with  his  own.  On  these  publica- 
tions, mainly,  Chalmers's  fame  rested.  A  careful,  stu- 
dious man  and  a  busy  writer,  he  became  known  to  the  pro- 
fession rather  than  to  the  laity,  and  lived  out  his  life  in 
Charleston,  where  he  died  in  1777.  He  never  returned  to 
Europe  or  was  enabled  to  reap  the  rewards  which  the 


74  MEDICINE    IN    AMERICA. 

report  of  his  work  and  writings  might  well  have  brought 
him  in  an  older  and  broader  community. 

The  last  and  most  famous  of  the  Charleston  group  was 
Alexander  Garden,  a  name  not  altogether  unknown  to 
the  casual  reader  of  our  own  time.  He  was  the  youngest 
of  the  four,  born  in  1730,  and  one  recalls  that  he  carried 
with  him  through  life  a  tuberculous  taint,  against  which 
he  fought  for  many  years.  He  died  of  a  consumption  in 
1792.  But  Garden  did  much  more  than  travel  for  his 
health.  He  was  born  in  Scotland,  as  we  know,  was  grad- 
uated from  the  University  of  Aberdeen,  and  went  to 
South  Carolina  about  1750.  More  than  other  Americans 
of  his  time,  with  the  possible  exception  of  Golden,  he  was 
a  highly  gifted,  widely  read,  and  cultivated  man.  He  was 
familiar  with  the  Greek  and  Latin  classics,  and,  what  was 
more  rare  in  those  days,  with  French  and  Italian;  while 
his  studies  embraced  medical  science,  botany,  mathe- 
matics, philosophy,  belles-lettres,  and  history.  Altogether 
he  seems  to  have  been  a  most  accomplished  and  agreeable 
person.  His  biographer  notes  complacently  that  he  was  a 
particular  favorite  in  "  refined  female  society,"  and  adds 
the  corollary  that  he  was  most  successful  in  his  practice. 
But  there  must  have  been  more  than  mere  accomplish- 
ments to  commend  Garden  to  the  world  of  science,  and 
that  he  was  held  in  high  regard  appears  from  the  fact  that 
he  was  made  a  Fellow  of  the  Royal  Society  of  London, 
while  still  residing  in  Charleston,  in  1772.  Fourteen  colo- 
nial Americans  received  this  honor,  of  whom  four  were 
physicians :  Boylston,  Mitchell,  Garden,  and  Morgan. 
Garden  was  a  painstaking  and  enthusiastic  totanist,  and, 
as  such,  corresponded  extensively  with  many  European 
naturalists.  Linnaeus,  who  regarded  him  highly,  gave  the 
name  Gardenia,  in  his  honor,  to  one  of  the  most  beautiful 
of  flowering  shrubs.  Indeed,  on  subjects  of  natural  his- 
tory Garden  was  a  frequent  writer,  and  the  "  Transactions 
of  the  Royal  Society"  contain  many  of  his  productions. 


THE    EIGHTEENTH    CENTURY.  75 

Garden  made  one  addition  to  our  Pharmacopoeia  for 
which  Lining  and  Chahiiers  have  often  received  equal 
credit, — that  very  useful  vermifuge,  spigelia,  or  pinkroot. 
As  a  matter  of  fact,  it  was  Garden  who  discovered  its 
properties  and  exploited  it,  and  his  one  elaborate  medical 
paper  which  we  have  deals  with  this  subject. 

In  spite  of  ambition  and  capacity,  the  early  years  of 
Garden's  practice  were  so  seriously  interrupted  by  ill 
health  that  in  1754,  four  years  after  coming  to  South 
Carolina,  he  was  obliged  to  take  a  voyage  for  his  recovery. 
While  on  his  travels,  he  stopped  for  some  time  in  New 
York,  where  he  was  offered  a  professorship  in  the  new 
college,  but  declined,  and  shortly  afterwards  returned  to 
settle  in  Charleston.  There,  for  nearly  thirty  years,  he 
continued  his  labors.  In  1783  he  returned  to  Europe. 
He  was  a  Tory,  and,  like  his  contemporary,  Bull,  found 
life  in  America  impossible  after  the  Revolution,  although 
he  had  a  son  who  served  in  the  American  army.  Arrived 
in  London,  Garden  was  warmly  received  by  his  many  ad- 
mirers there,  and  was  elected  a  Councillor  and  Vice-Presi- 
dent of  the  Royal  Society.  He  was  also  made  a  member 
of  the  Royal  Society  of  Upsala.  From  that  time  his  story 
consisted  mostly  of  rest,  social  triumphs,  and  travel  in  the 
pursuit  of  health.  In  his  native  land  his  tuberculosis  again 
became  active,  and  after  nine  years  of  such  existence  he 
died  in  London  in  1792. 

Such  were  some  of  the  doctors  who  lived  in  South  Caro- 
lina during  the  eighteenth  century;  these  five  the  most 
important,  it  would  appear.  They  were  not  epoch-makers ; 
we  cannot  well  remember  them  among  the  masters  in 
medicine;  but  for  the  time,  and  for  the  little  provincial 
town  in  which  they  lived,  they  were  men  of  unusual 
strength,  and  merit  a  place  in  our  annals.  There  were 
others,  —  many  others,  indeed,  —  Walter  and  Catesby 
among  them,  but  not  of  equal  fame. 

In  Virginia  some  few  are  also  to  be  found,  at  one  of 


76  MEDICINE    IX    AMERICA. 

whom  we  must  briefly  glance.  John  Mitchell,  of  Virginia, 
was  one  of  the  few  eminent  American  scientists  of  colonial 
days,  a  member  of  the  Royal  Society,  and  an  Englishman 
by  birth.  He  came  out  to  Virginia  in  the  early  part  of 
the  century,  not  far  from  the  year  1700,  settled  in  the  little 
town  of  Urbanna,  on  the  Rappahannock,  and  remained  a 
country  doctor  all  his  life. 

In  these  days  it  is  hard  for  us  to  conceive  how  a  man 
situated  as  was  Mitchell,  living  in  a  remote,  thinly  settled 
agricultural  community,  many  miles  from  the  nearest 
considerable  city,  Philadelphia,  and  months  in  time  of 
travel  from  the  01d-^^'orld  centres  of  learning,  could 
possibly  have  risen  to  such  distinction  as  became  his.  In- 
deed, we  are  fain  to  agree  with  Rush,  that  he  may  have 
been  a  man  of  remarkable  genius.  Yet  we  know  little  of 
the  man,  and  the  report  of  him  rests  mainly  on  two  essays 
which  he  wrote,  one  published  only  after  he  had  been 
many  years  in  his  grave.  Like  Garden  and  Colden,  both 
of  whom  he  came  later  to  know  and  esteem,  Mitchell  was 
attracted  especially  to  botany,  and  in  his  old  age  he  pub- 
lished a  work  on  that  science  and  described  several  new 
genera  of  plants.  His  earlier  work,  which  one  may 
find  in  the  "  Philosophical  Transactions"  for  1743,  was 
"  An  Essay  on  the  Causes  of  the  Different  Colors  of 
People  in  Different  Climates."  It  is  pleasant  reading  still. 
His  idea  was  that  the  color  in  whites  is  due  to  a  thin  epi- 
dermis transmitting  the  underlying  tissue  color;  that 
negroes'  skins  are  black  because  thick  and  dense;  that 
they  have  no  black  humors  in  their  skins.  So  texture,  not 
coloring  matter,  is  made  to  explain  the  conundrum ;  and 
we  are  told  that,  according  to  the  Scriptures,  the  primitive 
color  was  a  medium  between  white  and  black ;  from  this 
primitive  color  the  white  and  black  races  have  degen- 
erated, both  in  opposite  directions.  There  are  various 
other  essays  by  Mitchell,  published  in  the  "  Philosophical 
Transactions,"  but  the  work  for  which  he  became  best 


THE    EIGHTEENTH    CENTURY.  y-j 

known  was  that  posthumous  one  alluded  to  above.  It 
was  "  An  Account  of  the  Yellow  Fever  which  prevailed 
in  Virginia  in  the  years  i737-'4i-'42."^  Some  years 
after  Mitchell's  death  the  manuscript  of  this  paper  fell 
into  the  hands  of  Franklin  and  was  passed  on  to  Rush, 
through  ^vhom  eventually  it  was  published. 

On  these  two  articles  and  the  goodly  number  of  essays 
already  mentioned  Mitchell  rested.  Of  his  personality 
and  manner  of  life  we  know  little  more;  but  his  fame 
travelled  abroad,  and,  with  those  others  whom  we  know, 
he  was  honored  by  his  English  contemporaries. 

Now,  these  men,  selected  as  leading  scientific  Ameri- 
cans of  the  early  eighteenth  century,  are  few  in  number, 
to  be  sure,  but  in  a  certain  fashion  their  works  do  follow 
them,  and  they  have  served  to  demonstrate  the  best  sort 
of  lives  being  lived  in  those  times. 

The  next  generation  indeed  advanced.  The  seed  sown 
by  an  earlier  generation  soon  came  to  fruitage.  Ameri- 
can science  shifted  gradually  into  the  hands  of  American- 
born  men,  and,  beginning  with  the  company  which  de- 
clared for  the  patriot  side  in  the  Revolution,  we  find  a 
true  native  spirit  of  learning,  growing  wider  and  w^iser 
through  the  nineteenth  century. 


*  The  editors  of  the  Medical  and  Philosophical  Register  (New 
York),  vol.  iv.  p.  i8i  (1814),  published  the  paper  with  this  foot- 
note: 

"  A  series  of  highly  interesting  papers  on  the  Yellow  Fever,  which 
many  years  ago  prevailed  in  Virginia,  embracing  the  account  written 
in  1744,  by  the  late  Dr.  Mitchell  of  that  State,  with  a  reply  of  Dr. 
Colden  to  Dr.  Mitchell  and  a  subsequent  letter  of  Dr.  Mitchell  on 
the  same  subject,  was  placed  in  the  hands  of  Dr.  Hosack  (editor) 
by  the  late  Prof.  Rush  of  Philadelphia,  a  short  time  previous  to  his 
death.  On  the  character  of  Dr.  Mitchell  it  is  unnecessary  particu- 
larly to  remark.  He  was  a  distinguished  Fellow  of  the  Royal  Society 
of  London  and  eminent  as  a  physician  and  philosopher.  With 
Chalmers  and  Lining  of  South  Carolina  and  Alexander  and  Colden 
of  New  York,  he  has  done  much  for  the  advancement  of  medicine 
on  this  side  of  the  Atlantic." 


CHAPTER    IV. 

the  eighteexth  century.     coloxial  medicine  . 
(continued). 

We  may  say  truthfully  that,  up  to  the  middle  of  the 
eighteenth  century,  Boylston  was  the  only  American  phy- 
sician who  deser\'es  a  permanent  place  among  the  masters. 
We  saw  other  learned  men,  other  men  of  more  than  na- 
tional reputation;  some  of  them  thought  very  wise 
thoughts,  some  of  them  put  their  ideas  into  writing  more 
or  less  luminous,  and  some  added  their  mite  to  our  Phar- 
macopoeia; but,  with  the  exception  of  Boylston,  their 
striving  was  on  lines  already  marked  out  in  some  fashion. 
They  collated  and  expounded  ideas  already  in  vogue,  they 
made  no  brilliant  discoveries,  they  formulated  no  salient 
theories,  they  founded  no  school,  they  fostered  without 
materially  advancing  our  art. 

Now,  with  the  turn  of  the  century  we  come  to  a  gen- 
eration of  men  to  whom  these  words  no  longer  apply. 
Perhaps  they  were  no  more  able  than  their  predecessors, 
but  we  observe  this :  that  most  of  them  were  American 
born,  that  they  were  full  of  a  restless  energ}^  and  enthu- 
siasm strange  to  their  professional  forbears,  that  they  were 
filled  with  the  spirit  of  the  times,  and  were  patriots  in  the 
Revolution  when  their  sun^iving  elders  clung  to  the  Tory 
side;  and  that  to  them  belongs  the  founding  of  schools 
and  hospitals,  those  twin  advocates  and  exponents  of  the 
advance  of  medical  science. 

To  most  laymen  a  hospital  seems  a  very  obvious  thing, 
a  place  where  one  may  go  to  be  taken  care  of  in  case  of 
illness  or  accident ;  but  to  physicians  from  the  very  earli- 
est days  it  has  meant  much  more  than  that.  To  them  it  is 
as  much  an  educational  institution  as  a  refuge  for  the 
afflicted,  and  never  so  much  so  as  in  our  own  day.  In  a 
78 


THE    EIGHTEENTH    CENTURY.  79 

hospital  groups  of  cases  most  properly  may  be  studied, 
methods  of  treatment  may  be  inaugurated  and  tested, 
and  constant  observation  may  be  employed.  There  the 
sick-bed,  the  laborator\\  the  morgue,  and  the  operating- 
room  are  always  ready  and  fully  equipped.  There  the  stu- 
dents come  for  their  instruction  and  young  doctors  for  the 
perfecting  of  their  early  training ;  there  physicians  gather 
from  far  and  near  to  hear  and  to  see  the  latest  progress; 
and  there,  most  important  of  all,  the  visiting  staff  find 
opportunities  for  their  best  work,  and  in  a  congenial 
atmosphere  of  science,  unhampered  but  with  the  stimulus 
of  friendly  competition  and  with  the  necessity  of  teach- 
ing, advance  their  art  under  advantages  such  as  are 
known  to  no  other  branch  of  human  endeavor. 

These  great  and  important  functions  of  a  hospital,  so 
imperfectly  understood  even  in  our  own  day,  were  un- 
known to  laymen  one  hundred  and  fifty  years  ago;  but 
the  necessity  for  a  better  care  of  the  sick  poor  was  be- 
coming apparent  to  the  authorities  of  the  larger  towns, 
and  the  stimulus  necessary  for  their  action  was  happily 
furnished  first  in  Philadelphia,  through  the  energy  of 
Dr.  Thomas  Bond,  ably  and  effectively  seconded  by  Ben- 
jamin Franklin,  without  whose  influence  and  shrewd 
knowledge  of  men  the  enterprise  might  have  languished 
many  years  longer,  as  was  the  case  in  the  cities  of  New 
York  and  Boston. 

To  Philadelphia  our  country  is  indebted  for  number- 
less signal  advances  in  the  development  of  the  arts  and 
uses  of  peace,  and  the  medical  profession  must  never  for- 
get that  there  was  established  the  first  great  American 
hospital,  and  that  there  in  due  time  was  founded  the  first 
of  our  great  medical  schools. 

In  Thomas  Bond  there  is  an  apparent  exception  to  our 
understanding  that  the  inception  of  schools  and  hospitals 
belongs  to  a  generation  later  than  that  of  those  men 
already  described.     Indeed,  he  was  a  contemporary  of 


8o  MEDICINE   IN    AMERICA. 

Cadwallader  and  the  Charleston  group ;  but  he  was  one  of 
those  men  whose  energy  does  not  cease  with  their  youth ; 
and  altliough,  while  in  young-  middle  age,  he  founded 
the  Pennsylvania  Hospital,  he  continued  active  and  pro- 
gressive for  more  than  thirty  years  longer;  so  that  we 
think  of  him  as  a  contemporary  of  his  distinguished 
juniors,  Morgan  and  Shippen,  and  as  sharing  in  their 
labors. 

Bond  was  a  Marylander,  and  was  born  in  the  year  171 2. 
His  circumstances  were  comfortable,  and  he  was  enabled 
to  secure  an  excellent  medical  education.  Like  so  many 
of  his  colleagues  in  that  day,  he  was  not  graduated  in  arts, 
but  early  began  his  medical  studies  in  the  office  of  a  local 
practitioner,  a  Dr.  Hamilton;  and  having  passed  some 
six  years  under  such  tutelage,  went  to  Europe  for  broader 
learning. 

Such  foreign  study,  as  we  know,  was  no  new  thing  for 
young  colonials.  As  early  as  1642  Samuel  Bellingham, 
of  Harvard,  had  gone  to  Leyden  for  the  doctor's  degree ; 
in  1650  John  Glover  and  Leonard  Hoar  (later  Harvard 
Prasses)  had  gone  to  Aberdeen  and  Cambridge  for  the 
same  purpose;  and  there  were  several  others,  including 
Davis,  of  Harvard  (1674),  and  Bull,  of  Charleston 
(1734).  But  Bond  was  the  first  to  return  filled  with  the 
practical  idea  of  introducing  the  hospital  system  into  his 
native  land;  and  after  seventeen  years,  in  1751,  light 
began  to  shine  upon  his  enterprise.  Bond  came  home  in 
1734  and  settled  in  Philadelphia. 

During  those  middle  years  of  the  century  Pennsylva- 
nia's history  is  singularly  uneventful.  Except  for  political 
disputes  with  the  proprietaries  and  governors,  the  people 
of  the  colony  went  their  ways  peacefully  enough,  and  such 
domestic  conditions  doul^tless  existed  as  S.  Weir  Mitchell 
has  described  in  the  early  chapters  of  his  charming  tale, 
"  Hugh  Wynne." 

More  than  in  other  colonies,  then,  the  situation  favored 


THE    EIGHTEENTH    CENTURY.  8i 

studious  pursuits;  and  so  for  many  years  Thomas  Bond 
and  his  younger  brother  Phineas,  who  joined  him,  pro- 
gressed as  practitione-rs,  students,  and  writers.  Like  most 
of  the  writings  of  those  days,  the  pubhcations  were  de- 
scriptive and  ephemeral;  but  the  elder's  eyes  were  con- 
stantly open  to  the  possibility  of  medical  improvement, 
and  finally,  in  1751,  he  launched  seriously  his  propaganda 
for  the  establishment  of  a  great  municipal  hospital. 

It  must  not  be  supposed  that  nothing  in  the  nature  of 
provision  for  the  afflicted  had  ever  been  established  before 
in  the  colonies.  From  the  commercial  character  of  the 
country,  as  Beck  puts  it,  it  may  readily  be  supposed  that 
our  first  medical  establishments  were  lazarettos,  or  hos- 
pitals intended  for  the  reception  of  seamen  and  others 
infected  with  contagious  disorders.  Such  institutions 
existed  on  the  Delaware  River  and  in  Boston  Harbor,  and 
numerous  small  private  institutions  were  established  in 
different  parts  of  the  country  to  facilitate  the  practice  of 
inoculation  for  smallpox,  as  that  treatment  came  generally 
to  prevail.  But  these  were  not  hospitals  in  the  all- 
embracing  sense.  They  were  small,  very  limited  in  their 
means  and  scope,  and  in  the  lazarettos  especially  the 
medical  attendance  was  of  the  most  meagre  sort  and  the 
care  of  patients  inefficient  and  often  abominable. 

Now,  such  scant  accommodations  as  these  had  long 
ceased  to  meet  the  growing  needs  of  the  land;  but  our 
colonial  ancestors  were  in  many  ways  a  conservative  peo- 
ple; their  very  Revolution  was  but  a  standing  up  against 
innovation  and  a  harking  back  to  their  ancient  rights. 
It  was  not  easy  to  persuade  to  a  change  quiet  steady- 
going  communities  like  old  New  York,  Boston,  or  Phila- 
delphia ;  so  that  when  Bond  broached  his  scheme  for  a 
public  hospital  in  the  last  town,  his  friends  had  slight 
encouragement  for  him.  There  was  little  prospect  of  his 
project  going  through,  he  was  told;  but  as  a  first  step  he 
must  consult  Franklin. 

6 


82  AIEDICIXE    IN    AMERICA. 

This  was  just  the  sort  of  thing  to  appeal  to  that  vig- 
orous philosopher.  He  saw  at  once  the  value  of  the 
proposal  and  undertook  to  put  it  before  the  community. 

In  his  autobiography  Franklin  tells  us  the  tale  with 
characteristic  humor.  He  recognized  the  futility  of  ask- 
ing for  subscriptions  for  so  novel  a  project  before  a  pop- 
ular demand  had  been  created,  so  he  proceeded  to  create 
the  demand.  As  he  says,  '*  Previous,  however,  to  the 
solicitation  I  endeavored  to  prepare  the  minds  of  the 
people  by  writing  in  the  newspapers  on  the  subject,  which 
was  my  usual  custom  in  such  cases,  but  which  Dr.  Bond 
had  omitted." 

For  a  time  all  went  pleasantly  and  the  money  rolled 
up;  but  long  before  the  desired  amount  was  reached, 
enthusiasm  slackened,  and  it  became  evident  that  some- 
thing more  must  be  done.  With  that  Franklin  volunteered 
to  apply  to  the  Assembly. 

Now,  where  money  was  concerned,  this  Provincial  As- 
sembly of  Pennsylvania  was  the  most  stiff-necked  body  of 
men  in  all  the  colonies,  as  poor  dull  Braddock  and  others 
found  four  years  later;  but  in  the  present  case  Franklin 
worked  upon  the  members  with  his  usual  astuteness.  The 
opposition  came,  as  was  expected,  from  the  country  mem- 
bers, who  could  see  no  advantage  in  voting  public  moneys 
for  the  benefit  of  their  city  brethren,  and  said  further  that 
they  doubted  even  if  the  citizens  wanted  the  hospital.  The 
last  excuse  gave  Franklin  his  chance,  and  on  that  he  based 
the  phrasing  of  his  petition.  He  proposed  that  when  the 
contributors  to  the  hospital  fund  should  have  raised  their 
sum  total  to  two  thousand  pounds,  and  made  the  same 
appear  to  the  satisfaction  of  the  Speaker  of  the  Assembly 
for  the  time  being,  that  then  it  should  be  lawful  for  the 
Speaker  to  sign  an  order  on  the  provincial  treasurer  for 
another  two  thousand. 

Franklin  remarks  that  this  proposition  was  popular  at 
once,  and  in  its  workings  cut  both  ways.     Contributions 


THE    EIGHTEENTH    CENTURY.  83 

from  the  people  flowed  in  when  it  was  explained  to  them 
that  what  they  gave  should  be  doubled;  while  the  obsti- 
nate country  members,  confiding  in  the  reluctance  of  the 
citizens,  promptly  voted  for  the  bill,  thinking  cheaply  to 
gain  the  credit  for  ready  charity. 

As  Franklin  tersely  remarks,  "  The  subscriptions  ac- 
cordingly soon  exceeded  the  requisite  sum,  and  we 
claimed  and  received  the  public  gift,  which  enabled  us  to 
carry  the  design  into  execution." 

The  tale  of  the  building  and  equipping  of  that  first  hos- 
pital has  so  often  been  told  that  it  needs  no  repeating 
here.^ 

A  house  was  rented  on  the  south  side  of  Market  Street 
(then  High),  below  Seventh,  and  was  ready  for  patients 
in  February,  1752.  The  rules  provided  for  the  reception 
of  acute  cases  only,  excepting  the  contagious,  and  that 
the  city  poor  only  should  be  received  without  charge.  A 
number  of  regulations  were  adopted,  providing  for  the 
reception  and  care  of  persons  from  without  the  city.  The 
eighth  rule  reads  "  That  at  least  one  bed  shall  be  pro- 
vided for  accidents  that  require  immediate  relief." 

It  was  further  announced  that  paying  patients  would 
be  received  in  the  beds  left  over  after  all  charity  cases  had 
been  accommodated,  and  that  such  paying  patients  should 
be  allowed  to  employ  their  own  physician  or  surgeon. 

The  last  three  rules  are  to  the  effect  that  the  patients 
may  not  "  swear,  curse,  get  drunk,  behave  rudely  or  in- 
decently, on  pain  of  expulsion  after  the  first  admonition, 
that  there  shall  be  no  card  playing  or  dicing,  and  such 
patients  as  are  able  shall  assist  in  nursing  others,  wash- 
ing and  ironing  the  linen,  and  cleaning  the  rooms,  and 
such  other  services  as  the  matron  shall  require." 

These  rules  are  signed  by  Benjamin  Franklin,  Clerk, 


^  T.  G.  Morton,  History  of  the  Pennsylvania  Hospital,  1895 ;  F.  R. 
Packard,  The  History  of  Medicine  in  the  United  States,  1901. 


84  MEDICINE   IN    AMERICA. 

by  the  Speaker  of  the  Assembly,  and  by  the  Attorney- 
General. 

The  first  visiting  staff  consisted  of  Thomas  Bond,  Lloyd 
Zachery,  and  Phineas  Bond,  whose  services  were  rendered 
gratis.  There  was  also  a  consulting  staff  composed  of 
Cadwallader,  Graeme  Moore,  and  Redman. 

There  was  drawn  up  a  list  of  rules  governing  the  ap- 
pointments of  physicians  and  their  conduct, — rules  not 
very  dissimilar  from  those  in  force  to-day.  The  managers 
retained  all  powers  in  their  own  hands,  with  the  right  of 
dismissal  at  any  time,  although  the  physicians'  services 
were  gratis, — a  custom  which,  curiously  enough,  still  ob- 
tains throughout  the  land. 

Fortunately,  the  essential  ignorance  of  hospital  matters 
which  must  inhere  in  a  body  of  men  not  specially  trained 
is  usually  mitigated  by  the  presence  on  the  boards  of  one 
or  more  properly  qualified  physicians. 

So  the  Pennsylvania  Hospital  started  out,  humbly 
enough,  to  be  sure,  but  in  competent  hands;  and  after 
four  years  of  such  existence  the  corner-stone  of  the  present 
ancient  building  was  laid,  Franklin  writing  the  inscrip- 
tion: 

IN   THE   YEAR   OF   CHRIST 

MDCCLV 

GEORGE  THE   SECOND    HAPPILY   REIGNING 

(for    HE   SOUGHT   THE   HAPPINESS   OF    HIS    PEOPLE) 

PHILADELPHIA   FLOURISHING 

(for   ITS    INHABITANTS    WERE   PUBLICK    SPIRITED) 

THIS   BUILDING 

BY   THE   BOUNTY   OF   THE   GOVERNMENT, 

AND   OF   MANY   PRIVATE   PERSONS, 

WAS    PIOUSLY   FOUNDED 

FOR   THE   RELIEF   OF  THE   SICK   AND    MISERABLE; 

MAY   THE   GOD   OF    MERCIES 

BLESS    THE   UNDERTAKING 

It  is  needless  here  to  relate  further  the  history  of  this 
famous  institution.  The  three  great  names  connected 
with  its  first  half-century  are  those  of  Franklin,  Bond, 


THE   EIGHTEENTH    CENTURY.  85 

and  Rush,  and  it  continues  to-day  a  splendid  monument 
to  their  wisdom,  foresight,  and  abihty. 

Coincident  with  the  founding  of  the  hospital,  or  per- 
haps as  a  corollary  to  it,  was  the  establishment  of  a  Medi- 
cal Department  in  the  College  of  Philadelphia.  This  was 
so  pre-eminently  the  work  of  one  man,  Morgan, — most 
ably  seconded,  to  be  sure, — that  the  tale  of  his  short,  diver- 
sified, and  brilliant  career  best  illustrates  the  theme. 

We  have  seen  how  the  medical  ability  of  the  first  hun- 
dred years  of  the  American  colonies  exercised  itself  mostly 
in  practising  and  writing.  Incidentally,  of  course,  the 
doctor's  true  function,  teaching,  was  not  altogether  neg- 
lected; but  what  feeble  learning  was  developed  in  those 
earlier  days  depended  on  the  rough-and-ready  methods  of 
general  practitioners  and  the  dim  reflection  from  the 
European  universities. 

Although  Harvard  College  was  founded  in  1636,  Yale 
in  1 70 1,  and  other  similar  institutions  in  fairly  rapid  suc- 
cession, no  sustained  endeavor  had  been  made  for  the 
wider  training  of  professional  men  other  than  the  clergy 
until  the  pioneer  enterprise  of  the  College  of  Philadelphia, 
some  ten  years  before  the  Revolution. 

Benjamin  Rush  has  been  called  the  "  Father  of  Ameri- 
can Medicine,"  but  we  must  call  John  Morgan  its  grand- 
father. 

A  most  picturesque  personage  was  this  John  Morgan, 
like  so  many  others — masters  in  medicine — of  whom  we 
are  wont  to  think  well.  Indeed,  his  pleasing,  youthful 
countenance  and  that  expression  of  the  eyes  which  used 
to  be  called  sprightly,  as  he  looks  out  at  us  from  the  well- 
known  portrait,  are  suggestive  of  a  Waverley  hero  rather 
than  of  a  renowned  and  accomplished  physician. 

There  is  much  in  the  life  of  the  man,  especially  his  early 
life,  that  suggests  the  English  Sir  Astley  Cooper.  Of 
good  station  by  birth,  brought  up  among  the  best  people 
of  Philadelphia,  in  comfortable  circumstances,  aloof  from 


86  MEDICINE    IN   AMERICA. 

the  strenuous  necessity  of  the  frontier,  he  developed  a  pre- 
cocity and  a  love  of  science  which  promised  a  brilliant  and 
successful  future.  Wisely  he  was  restrained  from  too 
early  an  education,  and  much  of  his  boyhood  was  passed 
in  out-of-door  sports  and  pastimes.  At  the  age  of  twenty- 
one,  however,  he  was  graduated  in  arts  from  the  College 
of  Philadelphia,  in  1757,  with  the  first  class  of  that  insti- 
tution. Then  to  the  study  of  medicine.  We  know  the 
custom  of  medical  education  in  that  day.  Morgan  fol- 
lowed it,  and  began  his  studies  with  the  well-known  Dr. 
Redman,  of  Philadelphia. 

This  was  the  period  of  the  old  French  and  Indian  War, 
a  time  especially  propitious  for  the  practice  and  perfecting 
of  the  young  graduates,  and  Morgan  early  found  service 
in  the  English  and  colonial  armies.  The  experience  seems 
to  have  given  a  breadth  to  his  understanding  and  ambi- 
tions which  the  simple  training  of  his  old  preceptor  failed 
to  impart.  He  soon  found,  in  the  competition  which  he 
encountered  among  foreign  trained  surgeons,  that  his 
acquirements  were  by  no  means  commensurate  with  his 
ambitions,  so  in  1760  he  resigned  from  the  service  and 
went  to  Europe. 

Those  were  the  days  of  the  Hunter  brothers  in  London, 
and  with  the  elder,  William  Hunter,  Morgan  passed  many 
months  in  the  study  of  anatomy  and  surgery;  then  he 
went  to  Edinburgh,  where  he  became  the  friend  and  pupil 
of  Cullen,  the  Munros,  Rutherford,  Whytt,  and  Hope. 

There  he  spent  two  years,  and  was  graduated  a  Doctor 
of  Medicine  from  the  University.  Not  content  with  this 
extensive  training,  which  would  have  more  than  satisfied 
most  young  Americans  of  that  time,  he  repaired  to  Paris, 
studied  under  Sue,  and  was  admitted  to  the  Academy  of 
Surgery. 

His  travels  and  inquiries  took  him  farther, — to  Holland 
and  Italy.  It  is  told  of  him  that  he  had  a  long  interview 
with  Voltaire  in  Geneva  and  won  the  friendship  of  Mor- 


THE   EIGHTEENTH   CENTURY.  87 

gagni  in  Padua.  That  elderly  scholar,  already  in  his 
eightieth  year,  seems  to  have  been  something  of  a  wag, 
for  he  pointed  out  the  resemblance  between  his  own  name 
and  that  of  the  young  American,  claiming  distant  kin- 
ship,— a  fact  which  good  Dr.  Thacher  notes  with  cum- 
brous mirth. 

After  all  this  travelling  about  and  absorbing  of  useful 
information,  Morgan  returned  to  London,  where  he  was 
made  a  Fellow  of  the  Royal  Society,  a  member  of  the 
College  of  Physicians,  as  well  as  M.C.P.  of  Edinburgh. 

Morgan  had  spent  five  years  in  these  pleasant  pursuits 
and  goodly  company  before  he  found  it  convenient  to 
return  home ;  and,  fortunately  for  us,  besides  the  acquire- 
ment of  knowledge,  he  had  developed  a  very  real  and 
determined  purpose  to  exploit  his  learning  in  his  native 
town. 

There  is  no  reason  to  suppose  that  before  his  departure 
for  Europe  Morgan  had  entertained  any  definite  views  on 
the  founding  of  a  medical  school,  but  during  his  foreign 
travels  that  purpose  was  certainly  conceived  and  matured, 
and  in  the  development  of  his  plans  he  was  ably  assisted  by 
his  friend  and  fellow-townsman,  William  Shippen,  Jr. 
So  in  1765  he  returned  to  Philadelphia  laden  with  letters 
and  testimonials,  and  at  the  public  anniversary  commence- 
ment of  the  College  delivered  his  famous  "  Discourse  upon 
the  Institution  of  Medical  Schools  in  America."  ^ 


' "  It  is  now  more  than  fifteen  years  since  I  began  the  study  of 
medicine  in  this  city,  which  I  have  prosecuted  ever  since  without  in- 
terruption. During  the  first  years  I  served  an  apprenticeship  with  Dr. 
Redman,  who  then  did,  and  still  continues  to  enjoy  a  most  justly 
acquired  reputation  in  this  city  for  superior  knowledge  and  extensive 
practice  in  physic.  At  the  same  time  I  had  an  opportunity  of  being 
acquainted  with  the  practice  of  other  eminent  physicians  to  the  hos- 
pital, whose  prescriptions  I  put  up  there  above  the  space  of  one  year. 

"  The  term  of  my  apprenticement  being  expired,  I  devoted  myself 
for  four  years  to  a  military  life,  principally  with  a  view  to  become 
more  skilful  in  my  profession,  being  engaged  the  whole  of  that  time 
in  a  very  extensive  practice  in  the  army,  amongst  diseases  of  every 


88  MEDICINE   IN   AMERICA. 

This  discourse  of  Morgan  is  the  most  notable  Ameri- 
can educational  essay  of  the  eighteenth  century.  It  was 
far  from  being  purely  academic.  It  was  written  and  de- 
livered with  an  immediate  and  definite  purpose.  It  had 
been  conceived  years  before,  and  the  project  had  been 
gathering  force  with  the  broadening  intellectual  develop- 
ment of  its  author.  For  a  whole  year  it  had  been  held  in 
manuscript  form. 

Written  in  Paris  in  1 764,  it  had  been  frequently  revised, 
submitted  to  Hunter,  Fothergill,  and  Watson  in  London, 
and  was  worked  out  faithfully  to  meet  not  only  the  gen- 
eral proposition  of  medical  education,  but  especially  to 
cover  the  conditions  existing  in  immature  America.  After 
rehearsing  the  existing  status  of  American  medicine,  call- 
ing attention  to  the  growing  needs  of  the  country,  and 
describing  his  own  unusual  and  laborious  career  hitherto, 
Morgan  went  on  to  point  out  in  detail  the  proposed  cur- 
riculum, giving  their  proper  places  to  the  fundamental 
studies  of  anatomy,  physiology,  chemistry,  the  natural 
sciences,  the  theory  and  practice  of  physic,  surgery,  and 
midwifery.  He  earnestly  described  the  numerous  advan- 
tages which  would  come  to  the  profession  and  community 
by  the  formation  of  a  medical  school,  and  his  eloquence 
seems  so  to  have  roused  his  audience  that  the  foundation 
of  such  a  school  straightway  appeared  the  one  paramount 
interest. 

Besides  his  own  enthusiasm  and  prophetic  words,  Mor- 
gan had  come  home  laden  with  earnest  appreciative  letters 
from  his  friends  in  Europe,  notably  Thomas  Penn,  and 


kind.  The  last  five  years  I  have  spent  in  Europe,  under  the  most 
celebrated  masters  in  every  branch  of  medicine,  and  spared  no  labor 
or  expense  to  store  my  mind  with  an  extensive  acquaintance  in  every 
science  that  related  in  any  way  to  the  duty  of  a  physician;  having 
in  that  time  expended  in  the  pursuit  a  sum  of  money  of  which  the 
very  interest  would  prove  no  contemptible  income.  With  what  suc- 
cess this  has  been  done,  others  are  to  judge  and  not  myself." 


THE   EIGHTEENTH    CENTURY.  89 

these  writings  carried  no  little  weight  with  the  authorities 
at  home. 

It  would  not  be  fair  to  assume  that  Morgan  was  the 
only  promoter  of  the  scheme.  Mention  has  been  made  of 
William  Shippen,  Jr.  This  eminent  man  was  prepared, 
in  a  way  scarcely  inferior  to  his  friend  Morgan,  for  the 
new  undertaking.  The  two  were  born  in  the  same  year, 
1736.  Shippen  came  of  a  well-known  medical  family;  his 
father,  William  Shippen,  Sr.,  was  long  a  prominent  prac- 
titioner in  Philadelphia.  He  himself  was  liberally  edu- 
cated and  was  graduated  from  the  College  of  New  Jersey, 
as  Princeton  was  then  called. 

After  studying  some  time  with  his  father,  he,  too,  went 
to  Europe  and  enjoyed  the  instruction  of  John  Hunter  in 
anatomy  and  William  Hunter  and  McKenzie  in  mid- 
wifery ;  then  he  was  graduated  in  medicine  from  the  Uni- 
versity of  Edinburgh.  After  five  years  he  returned  to 
Philadelphia,  in  1762,  three  years  before  the  advent  of 
Morgan. 

Thoroughly  imbued  with  the  importance  of  medical 
teaching,  he  immediately  opened  a  course  of  lectures  on 
midwifery,  probably  the  best  special  course  on  that  sub- 
ject given  up  to  that  time  in  this  country. 

Such  private  teaching  as  that  instituted  by  Shippen  was 
not  an  absolute  novelty  in  America.  William  Hunter,  of 
Rhode  Island,  a  relative  of  the  famous  Scotch  Hunters, 
and  other  energetic  men  had  done  similar  work,  useful 
though  spasmodic ;  but  to  Shippen  has  been  given  a  credit 
and  honor  out  of  all  proportion  to  that  of  those  others. 

Controversy  over  such  a  matter  must  always  be  futile, 
but  one  can  hardly  feel  that  "  to  Shippen  more  than  any 
other  man"  is  due  the  advancement  of  medical  studies  in 
the  colonies.  Shippen  enthusiastically  taught  in  private 
while  still  a  young  man,  and  fame  came  to  him  later  as  a 
distinguished  University  professor.  Morgan  projected  a 
great  medical  school.    The  two  men — Morgan  and  Ship- 


90 


MEDICINE   IN   AMERICA. 


pen — were  in  close  touch  through  those  preparatory  years ; 
and  Morgan  in  London,  well  advised  of  Shippen's  lectures 
at  home,  corresponded  with  him  urgently  on  the  subject 
of  the  proposed  school. 

Thus  it  came  about  that  in  1765  the  two  young  men, 
then  but  twenty-nine  years  old,  approached  the  great  sub- 
ject with  almost  equal  preparation,  vigor,  and  enthusiasm. 
Their  zeal  was  so  infectious  and  their  fitness  so  apparent 
that  when  the  trustees  of  the  College  arranged  to  launch 
the  medical  school,  Morgan  and  Shippen  ^  were  at  once 
chosen  for  the  two  important  chairs  of  the  Theory  and 
Practice  of  Medicine  and  of  Anatomy  and  Surgery  respec- 
tively. 

From  the  outset  these  two  men  controlled  for  many 
years  the  policies  of  the  new  school,  and  their  recom- 
mendations were  promptly  accepted  by  the  trustees. 

The  College  was  to  confer  two  degrees  in  medicine, 
the  Bachelor's  and  the  Doctor's,  although  in  the  next  gen- 
eration the  Bachelor's  degree  was  abandoned.  As  to  that 
degree,  it  was  premised :  first,  that  the  candidate  for  ma- 
triculation should  show  efficiency  in  the  natural  sciences 


'  "  To  THE  Trustees  of  the  College^  etc.  : 

"  The  instituting  of  medical  schools  in  this  country  has  been  a 
favorite  object  of  my  attention  for  seven  years  past,  and  it  is  three 
years  since  I  proposed  the  expediency  and  practicability  of  teaching 
medicine  in  all  its  branches,  in  this  city,  in  a  public  oration,  read 
at  the  State  House,  introductory  to  my  first  course  of  Anatomy.  I 
should  have  long  since  sought  the  patronage  of  the  Trustees  of 
this  College,  but  waited  to  be  joined  by  Dr.  Morgan,  to  whom  I  first 
communicated  my  plan  in  England  and  who  promised  to  unite  with 
me  in  every  scheme  we  might  think  necessary  for  the  execution  of  so 
important  a  point. 

"  I  am  pleased,  however,  to  hear  that  you  gentlemen,  on  being 
applied  to  by  Dr.  Morgan,  have  taken  the  plan  under  your  protec- 
tion, and  have  appointed  that  gentleman  Professor  of  Medicine. 

"  A  professorship  of  Anatomy  and  Surgery  will  be  gratefully 
accepted  by,  gentlemen,  your  most  obedient  and  humble  servant, 

"  William  Shippen,  Jr. 

"  Philadelphia,  17th  September,  1765." 


THE    EIGHTEENTH    CENTURY.  91 

and  Latin,  and  that,  during  his  studies,  he  should  attend 
at  least  one  course  of  lectures  in  anatomy,  materia  medica, 
chemistry,  the  theory  and  practice  of  physic,  and  one 
course  of  clinical  lectures,  and  should  "  attend  the  prac- 
tice" of  the  Pennsylvania  Hospital  for  one  year,  after 
which  he  should  be  admitted  to  the  examination  for  the 
Bachelor's  degree.  It  was  further  provided  that  he  must 
also  have  served  an  apprenticeship  with  some  physician. 
Then  for  the  later  Doctor's  degree  the  candidate  must  wait 
three  years  and  write  and  defend  a  thesis. 

Such  was  the  extent  of  education  required  in  those  early 
days.  It  was  a  very  great  step  in  advance ;  it  meant  more 
than  we  are  wont  to  allow.  The  long  apprenticeship  pre- 
ceding the  lecture  course  was  a  very  real  thing,  an  era  of 
hard  work  and  much  faithful  reading.  The  student  was 
constantly  under  the  eye  of  a  competent  master;  he  re- 
ceived personal  instruction,  and  his  individual  needs,  fail- 
ings, and  capacities  were  better  known  and  observed  than 
became  possible  in  that  long  subsequent  era  in  the  next 
century  when  students  herded  in  great  classes,  unindivid- 
ualized  and  almost  unknown  to  their  teachers. 

In  these  later  days  we  have  returned  in  a  large  measure 
to  the  personal  teaching,  and  with  wider  knowledge ;  but 
the  early  simple  method  had  much  of  merit.  The  one  year 
of  lectures  and  study  seems  to  us  now  all  too  short,  but 
we  must  remember  the  foregoing  apprenticeship;  and 
then  the  Doctor's  degree  was  withheld  until  after  three 
years  of  approved  work. 

The  one  flaw  in  the  carefully  prepared  scheme,  how- 
ever, was  the  fact  that  for  most  men  of  the  unambitious 
kind  that  Bachelor's  degree  sufficed.  They  left  the  school 
after  one  year,  with  the  license  to  practise;  they  were 
called  "  Doctor"  by  their  neighbors,  and  were  satisfied 
with  that.  Why  should  they  weary  themselves  with  study 
and  further  public  speaking  before  a  strange  and  critical 
audience,  merely  to  write  M.D.  for  M.B.  as  their  title? 


92  MEDICINE    IN   AMERICA. 

That  explains  the  infrequency  of  the  Doctor's  degree  in 
the  old  lists  and  the  traditional  respect  for  those  two 
letters,  M.D.,  now  held  by  groaning  thousands  in  the 
land. 

Two  other  men  were  added  shortly  to  the  little  staff: 
Adam  Kuhn,  Professor  of  Materia  Medica  and  Botany, 
and  Benjamin  Rush,  Professor  of  Chemistry.  Kuhn  was 
appointed  in  1768,  when  he  was  but  twenty-seven  years 
old.  Born  and  bred  in  Philadelphia,  he  was  educated  at 
the  University  of  Upsala,  where  he  became  a  favorite  of 
Linnaeus;  then  he  went  to  Edinburgh,  was  there  gradu- 
ated in  medicine  in  1767,  and  returned  to  Philadelphia 
the  following  year.    His  lectures  began  in  1769. 

Rush  was  still  younger.  Born  in  1745,  he  was  but 
twenty- four  at  the  time  of  his  appointment ;  and  although 
already  prominent,  his  later  and  multiplied  activities  were 
so  conspicuous  that  he  seems  to  belong  to  another  gen- 
eration, with  which  must  be  told  the  story  of  his  life. 

For  many  years  after  their  founding,  the  hospital  and 
medical  school  struggled  on,  often  against  heavy  odds. 
The  four  young  men,  upon  whom,  with  Bond,  the  burden 
of  teaching  rested,  were  soon  overwhelmed  with  cares; 
for  the  Revolution  was  impending,  and  their  abilities 
and  zeal  were  claimed  by  their  struggling  compatriots 
in  arms. 

The  Commencement  of  1771  must  be  noted,  for  it  is  a 
landmark.  In  June  of  that  year  there  returned  for  the 
Doctor's  degree  four  men  who  had  been  graduated  Bach- 
elors of  Medicine  in  1 768 :  Jonathan  Elmer,  Jonathan 
Potts,  James  Tilton,  and  Nicholas  Way,  the  first  Doctors 
of  Medicine  graduated  in  Philadelphia. 

Strangely  enough,  though  Philadelphia  established  the 
first  medical  school,  and  granted  the  first  degrees  of  B.M., 
it  did  not  graduate  the  first  doctors.  The  Medical  School 
of  New  York,  established  in  1768,  gave  the  B.M.  in  1769, 
and  the  first  Doctor's  degree  granted  on  this  continent 


THE    EIGHTEENTH    CENTURY.  93 

was  bestowed  there,  in  1770,  upon  Robert  Tucker,  and  the 
second,  in  May,  1771,  upon  Samuel  Kissam. 

The  Philadelphia  school  knew  many  vicissitudes  before 
it  gathered  mature  strength.  During  the  Revolution  it 
languished;  a  few  scattered  lectures  were  given  in  those 
years,  but  teachers  and  students  were  mostly  busy  with 
other  things.  Some  of  the  trustees  were  Tories,  although 
most  of  them  were  Whigs;  but  the  College  came  under 
popular  suspicion,  and  in  1779  the  Assembly  revoked  its 
charter  and  conferred  its  powers  and  privileges  upon  the 
University  of  the  State  of  Pennsylvania. 

Then  ensued  turmoil,  struggle,  and  heart-burning 
which  avail  nothing  in  the  telling.  The  new  University, 
with  its  grander  name,  was  the  favorite  of  patriots, — 
unjustly  so,  it  seems ;  but  most  of  the  old  College  teachers 
refused  to  join  the  new  movement.  Indeed,  Shippen  was 
the  only  one  who  accepted  at  once  a  professorship  in  the 
University.  Later  others  joined  him;  but  after  the  war 
Benjamin  Franklin  and  old  friends  of  the  College  renewed 
their  efforts  to  remove  the  stigma  on  its  good  name,  with 
the  result  that  its  charter  was  restored  in  1783;  the  old 
professors  were  reinstated, — Shippen  and  all ;  and  finally, 
in  1 79 1,  the  two  institutions  were  united  under  the  title  of 
"  The  University  of  Pennsylvania,"  which  still  flourishes 
in  our  midst. 

In  the  middle  of  the  eighteenth  century  New  York  was 
a  very  pleasant  place,  for  there  lived  and  practised  medi- 
cine there  Dr.  John  Bard,  of  whom  Thacher  says,  "  By 
the  urbanity  of  his  manners,  his  professional  talents,  and 
the  charm  of  his  conversation,  which  was  enlivened  by 
an  uncommon  flow  of  cheerfulness,  enriched  by  sound 
sense  and  adorned  by  a  large  fund  of  anecdote,  he  so 
effectually  recommended  himself  to  the  notice  and  friend- 
ship of  the  most  respectable  families,  that  he  was  almost 
immediately  introduced  into  a  valuable  scene  of  business 
and  very  soon  arrived  at  the  first  rank  of  professional 


94  MEDICINE    IN    AiAIERICA. 

eminence,  which  he  retained  through  a  long  hfe  of  more 
than  fourscore  years." 

The  man  was  truly  eminent.  He  proved  himself  New 
York's  earliest  efficient  quarantine  officer ;  he  was  an  inde- 
fatigable worker;  surviving  the  Revolution,  he  was  the 
first  president  of  the  Medical  Society  of  New  York,  and 
he  was  the  father  of  an  even  more  distinguished  son, 
Samuel  Bard. 

It  seems  fair  to  say  that  Samuel  Bard  was  the  most 
eminent  American  physician  of  his  time,  with  the  single 
exception  of  Benjamin  Rush.  His  life  was  long,  his  expe- 
riences varied  and  extensive,  his  acquaintance  wide,  and 
his  services  to  American  medicine  of  the  greatest  value. 
Among  his  earliest  and  most  notable  achievements  was 
his  part  in  the  founding  of  the  medical  school  and  hospital 
in  New  York;  and  his  efforts  continued  through  more 
than  forty  years,  against  the  most  discouraging  conditions, 
to  foster  and  promote  medical  education. 

It  would  not  be  fair,  however,  to  assign  to  him  alone 
the  credit  for  these  good  works.  More,  perhaps,  even 
than  Philadelphia,  New  York  was  supplied  with  a  body 
of  excellent  physicians,  and  the  starting  of  a  school  in 
emulation  of  Philadelphia  was  the  result  of  their  com- 
bined efforts;  but  Bard  was  the  most  constant  and  ur- 
gent of  them  all,  and  after  the  school  was  under  way  he 
did  not  rest  until  he  had  founded  and  helped  to  launch 
a  proper  hospital. 

There  is  abundant  material  for  a  sketch  of  Samuel 
Bard's  life;  indeed,  the  Rev.  John  McVickar,  quoted  by 
Thacher,  has  given  a  long  account  thereof;  but,  as  he 
tells  it,  it  was  not  of  so  much  interest  in  itself  as  it  was 
notable  for  the  shifting,  varied  scenes  through  which  it 
passed. 

Samuel  Bard  was  not  a  native  of  New  York.  At  the 
time  of  his  birth  (1742)  his  father  was  an  active  medical 
practitioner  in  Philadelphia,  but  shortly  after  removed  to 


THE    EIGHTEENTH    CENTURY.  95 

New  York,  where  he  acquired  that  popularity  which  we 
have  seen.  The  son  grew  up  there,  and  was  educated  at 
King's  College,  whence  he  was  graduated  in  1 76 1 .  During 
his  boyhood  he  had  the  advantage  of  an  intimacy  with  the 
Colden  family,  and  spent  many  months  at  their  country 
place  on  the  Hudson.  It  all  sounds  so  familiar  and  mod- 
ern that  we  are  wont  to  forget  that  those  were  the  days 
of  "  The  Last  of  the  Mohicans,"  and  that,  within  fifty 
miles  of  Coldenham,  Indians  were  roving  the  woods  and 
white  scalps  were  occasionally  being  taken.  However, 
Bard  was  safe  from  all  that. 

If  one  remembers  that  he  was  about  ten  years  Wash- 
ington's junior,  one  can  more  readily  conceive  the  sort  of 
men  and  manners  that  he  knew.  At  the  age  of  nineteen 
he  went  to  London  and  Edinburgh,  receiving  the  degree 
of  the  latter  University  in  1765 ;  so  we  see  that  he  was  a 
little  younger  than  his  friend  Morgan,  but  was  brought 
under  the  same  influences  in  the  course  of  his  education. 
He,  too,  was  filled  with  the  thought  of  an  American  school 
of  medicine,  and,  largely  through  his  urging,  the  race 
for  first  place  between  New  York  and  Philadelphia  was  a 
close  one. 

The  experience  of  Bard  differed  much  from  that  of 
Morgan  in  the  scope  and  choice  of  his  associates  in  the 
proposed  undertaking.  The  Philadelphia  school  was  the 
project  of  young  men,  conducted  by  young  men.  Bard, 
in  New  York,  became  at  once  associated  with  an  older 
generation,  waiting,  apparently,  for  the  impulse  which  he 
could  give.  Five  of  those  older  men  became  his  col- 
leagues, and  in  the  year  1768  the  Medical  School  of 
King's  College  was  established. 

The  chairs  were  held  by  Samuel  Clossy,  Anatomy; 
John  Jones,  Surgery;  Peter  Middleton,  Physiology  and 
Pathology;  James  Smith,  Chemistry  and  Materia  Med- 
ica ;  John  V.  B.  Tennent,  Midwifery ;  and  Samuel  Bard, 
Theory  and  Practice  of  Physic.     To  one  in  any  way 


96  MEDICINE    IN    AMERICA. 

acquainted  with  the  hfe  of  old  New  York  every  one  of 
these  names  is  full  of  interest  and  suggestion,  but,  with 
one  or  two  exceptions,  they  must  be  passed  by  quickly. 

Clossy  was  a  clever  Irishman  who  had  been  but  four 
years  in  America.  His  reputation  was  made  in  the  6ld 
country,  and  he  had  published  a  treatise  on  Morbid  Anat- 
omy. The  Revolution  saw  the  end  of  him,  for  he  was  an 
Irish  Tory  and  went  back  to  his  native  land. 

John  Jones  was  of  quite  another  type.  First  and  last, 
a  good  deal  has  been  written  of  him.  He  was  a  first-rate, 
hard-working,  well-educated  doctor,  with  a  line  of  Penn- 
sylvania and  Welsh  ancestors,  —  Wynnes,  Stephensons, 
and  such  among  them.  As  we  should  expect,  he  was  edu- 
cated in  Europe,  and  when  he  came  home,  in  1753,  he  had 
the  ambition  to  devote  himself  to  surgery, — a  unique  am- 
bition there  and  then.  I  suspect  that  his  Paris  experience 
led  him  that  way.  He  had  come  under  Petit  and  Le 
Dran, — the  latter,  perhaps,  the  most  stimulating  teacher 
of  his  time;  his  writings  are  delightful  and  full  of  new 
facts  even  to-day.  Jones  had  a  good  trial  of  military 
surgery,  too.  In  the  early  days  of  the  old  French  AVar 
he  volunteered  as  surgeon,  saw  much  service,  and  did 
rhuch  good  work.  Indeed,  he  became  so  well  known  that 
Baron  Dieskau,  wounded  and  captured  at  Lake  George, 
asked  to  be  put  under  his  care.  Jones  returned  to  private 
practice  after  this  campaign. 

He  was  seven  years  older  than  Morgan,  who  entered 
the  army  some  five  years  after  Jones  himself,  and  the  two 
men  came  to  know  each  other  well  in  later  strenuous  times. 
He  was  a  straightforward,  independent  man,  free  from 
humbug,  and  those  qualities  got  him  into  trouble  with  his 
colleagues  in  his  early  days.  The  circumstance  throws  a 
curious  light  on  the  professional  habits  of  the  time. 

For  some  foolish  reason  the  New  York  doctors  thought 
it  wise  to  adopt  a  peculiarity  of  costume  which  might  dis- 
tinguish them  from  the  general  public.    Accordingly  they 


THE   EIGHTEENTH    CENTURY.  97 

decided  to  have  their  hair  dressed  after  a  particular  fash- 
ion. Most  of  the  better-known  practitioners  adopted  it; 
but  Jones  thought  it  absurd,  and  would  have  none  of  it. 
So  he  came  to  be  cut  by  many  of  his  friends  and  hated  by 
others.  One  man  even  went  so  far  as  to  refuse  to  meet 
him  at  a  consultation  demanded  by  a  patient,  and  ex- 
plained his  reasons.  That  was  the  end  of  the  hair-dress- 
ing business.  The  public  laughed  at  the  new  decorations, 
and  employed  Jones,  with  the  effect  on  the  pigtails  which 
we  might  expect;  so  Jones  became  a  successful  man,  and 
not  altogether  by  reason  of  his  straight  hair. 

He  did  many  good  things  in  the  world ;  taught  surgery 
well,  among  other  doings,  having  learned  how  from  his 
old  friend  and  master  in  London,  Percival  Pott.  He 
wrote  a  book,  too,  for  the  Revolutionary  surgeons: 
"  Plain,  Concise,  and  Practical  Remarks  on  the  Treatment 
of  Wounds  and  Fractures."  Altogether  he  was  an  inter- 
esting and  useful  person. 

Peter  Middleton  was  older  than  most  of  his  teaching 
colleagues.  A  Scotchman  born,  he  came  out  to  New  York 
about  1745,  and  was  for  many  years  a  conspicuous  prac- 
titioner. His  work  and  opinions  are  constantly  referred 
to  by  his  contemporaries,  but,  beyond  the  words  of  others, 
we  have  little  of  his  own  by  which  to  judge  him.  At  the 
opening  of  the  medical  school  he  delivered  an  address  on 
the  History  of  Medicine,  to  which  all  the  biographers 
refer.  One  reads  it  sadly  and  with  labor.  Writing  was 
not  the  good  man's  forte. 

Of  his  pathological  lectures  one  thinks  with  some  com- 
punction for  the  audience ;  but  I  know  not :  he  may  have 
been  more  luminous  than  we  are  aware. 

Then  there  was  James  Smith,  the  chemist,  of  whom  we 
know  only  that  he  was  a  brother  of  the  historian  of  New 
York. 

And,  lastly,  John  V.  B.  Tennent,  of  New  Jersey,  a 
learned  man  and  member  of  the  Royal  Society,  who  be- 

7 


98  MEDICINE   IN    AMERICA. 

came  distinguished  as  an  obstetrician,  and  was  called  to 
the  chair  of  Midwifery  in  the  new  school. 

Of  the  last  two  (Smith  and  Tennent)  there  is  little  to 
tell.  The  latter  died  young,  but  the  founding  of  a  chair 
of  Midwifery  is  a  note  of  interest. 

Up  to  the  middle  of  the  century  obstetrics  had  been 
mostly  in  the  hands  of  untrained  women  throughout  the 
country.  The  mothers  of  the  land  gave  birth  to  their 
children  with  little  other  care,  so  that  one  may  imagine 
what  a  godsend  it  was  when  James  Lloyd,  of  Boston,  came 
home  from  London  in  1752,  well  equipped  to  take  up  this 
special  line  of  work.  Then,  ten  years  later,  came  Shippen 
to  Philadelphia  and  Tennent  to  New  York.  Moultrie,  of 
Charleston,  too,  had  become  the  refuge  and  solace  of  those 
Southern  ladies  of  whom  we  know. 

Meantime,  in  New  York  the  medical  school  is  being 
founded,  with  Bard,  Jones,  and  Middleton  its  most  dis- 
tinguished lights ;  Bard  much  the  youngest  of  all :  twenty- 
six  years  old  only ;  very  full  of  the  energy  of  youth. 

Besides  his  energy  and  learning,  he  had  brought  with 
him  a  piece  of  advice  from  good  Dr.  Fothergill,  of  Lon- 
don. At  parting,  Fothergill  told  Bard  this  of  his  own 
great  success :  "I  crept  over  the  backs  of  the  poor  into 
the  pockets  of  the  rich."  Truly,  a  text  for  a  young  man. 
The  biographer  hastens  to  explain  that  this  is  not  so  bad 
as  it  sounds.  Elaborated,  read  it  thus :  "  Practice  among 
all  classes;  be  indispensable  to  the  whole  community; 
your  work  among  the  rich  is  uncertain,  their  patronage 
limited  and  fickle;  with  the  confidence  of  the  masses  be- 
hind you,  you  can  always  retrieve  misfortune."  Such 
thoughts  are  shrewd  and  salient  among  us  to  this  day. 

So  the  school  was  founded,  to  flourish  fitfully  and  pain- 
fully, shattered  and  obstructed  by  war  and  rivalry  for 
many  years.  We  chronicle  it  here  because,  with  its  Phila- 
delphia comrade,  it  knew  colonial  days.  The  course  of 
studies  was  much  like  that  of  Philadelphia :   a  Bachelor's 


THE    EIGHTEENTH    CENTURY.  99 

degree  conferred  after  one  year,  and  the  Doctor's  degree 
given  after  a  wait  of  only  one  year  more.  So,  as  was 
said,  the  first  Doctors  of  Medicine  graduated  in  the  land 
were  New  Yorkers :  Robert  Tucker,  1 770,  and  Samuel 
Kissam,  1771. 

In  connection  with  the  founding  of  these  two  schools 
it  is  interesting  to  note  that  Morgan  and  Middleton,  the 
respective  initial  spokesmen,  place  the  highest  value  on 
a  broad  preliminary  education, — an  equipment  which  only 
now,  after  the  lapse  of  more  than  a  century  and  a  quarter, 
we  are  beginning  to  demand  of  the  matriculates  in  our 
leading  schools. 

Both  Morgan  and  Middleton  were  men  of  wide  culture 
for  their  time,  or  any  time.  In  our  glance  over  the  med- 
ical conditions  existing  in  colonial  America,  we  have  taken 
note  of  a  few  conspicuous  figures ;  but  we  must  not  forget 
that  the  rank  and  file  of  our  doctors  were  sadly  ignorant 
and  untrained.  Quick  intelligence  and  little  knowledge 
had  brought  the  profession  to  a  lamentable  pass.  Quack- 
ery flourished  untrammelled;  the  few  regulating  laws 
were  futile  to  oppose  or  suppress  it.  Long  separation 
from  Europe  and  a  lack  of  American  schools  had  sunk  the 
standard  of  requirement  to  such  a  point  that  the  lapse  of 
a  whole  intervening  century  has  hardly  sufficed  to  oblit- 
erate the  reproach,  to  raise  us  to  the  European  standard, 
and  to  place  the  whole  body  of  physicians  on  the  plane  of 
the  other  professions.    Much  yet  remains  to  be  done. 

No  better  schools  than  our  best  schools  are  to  be  found 
in  the  world ;  nowhere  in  the  world  are  to  be  found  schools 
as  bad  as  our  worst. 

The  early  years  of  the  New  York  school  were  even  more 
checkered  than  those  of  the  College  of  Philadelphia.  The 
Revolution  bore  hardly  on  the  former  city,  and  for  six 
years  the  town  was  occupied  by  British  armies,  whose 
presence  put  an  end,  for  the  time,  to  the  College  work. 
The  faculty  was  divided  sharply  on  the  great  political 


100  MEDICINE    IN   AMERICA. 

question,  and  after  the  restoration  of  peace  never  came 
together  again  as  a  unit.  Three  years  after  the  war  an 
attempt  to  reorganize  the  medical  school  failed,  though 
the  College  went  on  under  its  new  name,  Columbia. 
Again,  in  1792,  the  school  started  up  feebly,  with  Bard 
at  the  head  of  the  faculty,  and  through  many  years  strug- 
gled, hampered  constantly  by  dissensions  in  the  profes- 
sion itself  and  what  seem  to  us  now  almost  unaccountable 
jealousies  between  the  leading  physicians  of  the  city. 

Early  in  the  last  century,  to  complicate  the  situation, 
the  New  York  University  started  a  medical  school  of  its 
own,  and  gave  it  the  name  now  famous,  "  The  College  of 
Physicians  and  Surgeons."  This  was  in  1807,  and  the 
teaching  staff  numbered  many  well-known  men  among 
its  members.  But  the  new  institution  soon  got  into 
trouble.  Dissensions  in  the  faculty  brought  it  to  a  low 
ebb,  and  the  lack  of  consistent  courses  so  discouraged  the 
students  that  there  was  a  great  falling  off  in  their  num- 
bers. The  fact  seems  to  have  been  that  there  was  not  in 
New  York,  at  that  time,  clinical  material  and  teaching 
talent  enough  for  the  successful  conduct  of  two  schools. 
The  only  remedy  lay  in  a  union,  and  in  the  year  181 1  this 
was  successfully  accomplished.  The  two  were  united 
under  the  name  of  the  younger,  old  Samuel  Bard  was 
made  president,  an  efficient  and  congenial  faculty  was 
selected  from  the  rival  staffs,  and  the  College  of  Physi- 
cians and  Surgeons  started  prosperously  out  on  its  long 
and  successful  career. 

The  Medical  School  of  King's  College  had  been 
founded  and  the  Philadelphia  Hospital  had  flourished  for 
twenty  years  before  the  establishment  of  the  New  York 
Hospital.  This  reversal  of  the  usual  order  of  events  was 
common  to  both  New  York  and  Boston.  To  our  modem 
view  a  medical  school  cannot  exist  without  a  hospital  as 
a  background,  and,  indeed,  that  has  been  the  usual  experi- 
ence of  the  world;   but  in  New  York  and  Boston,  in  the 


THE   EIGHTEENTH    CENTURY.  loi 

eighteenth  century,  schools  existed  some  years  before  the 
hospitals.  In  New  York,  indeed,  the  hospital  was  not 
firmly  and  fairly  established  until  twenty  years  after  its 
first  projecting;  and,  first  and  last,  it  was  to  Samuel  Bard 
that  it  owed  most. 

Before  a  distinguished  audience,  at  the  King's  College 
Commencement,  in  May,  1 768,  Bard  pleaded  so  eloquently 
the  importance  and  necessity  of  a  hospital  that  it  was  at 
once  taken  in  hand  by  the  citizens.  Governor  Sir  Henry 
Moore  heading  the  list  and  urging  it  upon  the  Legisla- 
ture. The  enterprise  was  successful  without  any  of  the 
shifts  and  difficulties  previously  encountered  in  Philadel- 
phia. The  citizens  subscribed,  the  Legislature  granted 
an  annual  allowance  of  eight  hundred  pounds  for  twenty 
years,  and  the  corporation  of  the  city  voted  a  suitable 
building  site. 

Nor  were  foreign  friends  lacking.  Dr.  Fothergill,  of 
London,  the  same  who  had  so  shrewdly  advised  Bard  how 
best  to  reach  the  pockets  of  the  rich,  had,  with  the  aid  of 
Sir  William  Duncan,  raised  a  considerable  sum  for  the 
hospital. 

Dr.  Fothergill  is  a  man  for  whom  American  doctors 
should  cherish  a  kindly  regard.  He  liked  us  and  our  ways, 
our  students  in  London  found  a  ready  friend  in  him,  and, 
like  Charles  James  Fox,  he  remained  always  our  stanch 
champion.  This  New  York  Hospital  business  was  not  the 
first  of  his  good  deeds  of  that  kind.  He  had  helped  the 
Pennsylvania  Hospital  years  before  with  books,  pictures, 
and  anatomical  casts,  and  had  stirred  up  Thomas  Penn  to 
send  a  chemical  outfit. 

In  1770,  then.  Bard,  Jones,  and  Middleton  petitioned 
their  friend,  Cadwallader  Colden,  to  further  this  great 
object  of  his  professional  colleagues;  and  the  old  man, 
then  Lieutenant-Governor,  granted  a  charter  of  incor- 
poration for  the  hospital,  under  the  title  "  The  Society 
of  the  Hospital  of  the  City  of  New  York  in  America." 


I02  MEDICINE    IN   AMERICA. 

The  work  went  vigorously  forward.  Money  was  con- 
tinually solicited  and  raised  in  a  variety  of  ways,  elabo- 
rate plans  were  drawn  after  a  scheme  devised  by  Jones 
during  a  visit  to  London  in  1772,  and  early  in  1775  a  fine 
stone  building  was  practically  completed,  when  it  took 
fire  and  burned  to  the  ground.  Then  they  went  to  work 
again  and  drew  new  plans  and  raised  more  money  and 
built  another  building,  and  the  first  use  they  put  it  to  was 
the  holding  of  the  Provincial  Congress  there  in  the  second 
year  of  the  Revolution,  April,  1776. 

Soon  the  Continental  surgeons  got  to  work,  without 
disturbing  the  Congress,  it  would  seem,  and  the  hospital 
was  found  a  very  present  help  in  time  of  trouble.  Indeed, 
the  first  operation  was  done  there  in  July  of  that  same 
year  by  Samuel  Drowne,  an  army  surgeon's  mate.  To 
such  work,  however,  there  came  speedily  an  end.  The 
British  arrived ;  the  hospital  was  turned  into  a  barracks ; 
and  Bard,  Jones,  and  Middleton  went  their  several  ways : 
the  first  two  with  the  Continental  armies.  The  last  re- 
mained at  home,  under  the  enemy's  protection,  feeble  in 
health,  to  die  before  the  war  came  to  a  close. 

Such,  most  briefly,  is  the  tale  of  the  hospital's  found- 
ing :  a  founding  so  tedious  and  retarded  that  its  purposes 
were  never  devoted  to  New  York  folk  as  colonials;  but 
the  men  who  projected  it  and  struggled  in  its  cause  were 
colonial  men,  and  so  the  subject  merits  these  few  words 
here. 

Even  after  the  war  the  tale  wanders  feebly  on  for  ten 
more  years,  of  which  years  and  events  notice  must  be 
taken  in  their  place.  Suffice  it  that  in  1791  the  hospital 
was  finally  and  successfully  equipped  and  started  on  its 
course. 


INTRODUCTION    TO    CHAPTER   V. 

Before  going  further  with  our  tale,  it  is  well  to  glance 
briefly  at  the  conditions,  political  and  scientific,  which 
obtained  in  Europe  about  the  era  of  the  American  Revo- 
lution. 

With  the  accession  of  George  III.,  in  1760,  there  was 
inaugurated  an  attempt — ^brief  and  inglorious — to  return 
to  the  system  of  one-man  power  in  the  state.  The  story 
of  the  feeble  and  foolish  struggles  of  this  narrow-minded 
king  needs  no  repetition  in  detail.  He  sought  to  make 
his  personal  wishes  paramount  in  the  national  councils; 
and,  realizing  the  danger  of  frank  despotism,  he  tried  to 
attain  his  ends  through  the  use  of  a  weak-kneed  and  com- 
placent ministry,  sustained  by  and  drawn  from  the  ranks 
of  a  venal  and  debauched  party. 

So  far  as  America  was  concerned,  there  followed  the 
successful  termination  of  the  old  French  and  Indian  War 
in  1763  and  the  Peace  of  Paris,  which  left  Canada  and 
Florida  in  the  possession  of  the  British,  with  the  Missis- 
sippi River  the  western  boundary  of  the  colonies;  the 
passage  of  the  Stamp  Act  in  1 765  and  its  repeal  in  i  yGG ; 
the  imposing  of  various  offensive  duties,  including  that 
on  tea  in  1767;  the  creation  of  custom-houses  and  the 
quartering  of  troops  in  America ;  the  so-called  "  Boston 
Massacre"  in  1770;  the  "Boston  Tea-Party"  in  1773; 
the  Boston  Port  Bill  in  1774;  the  capital  trials  act  in  the 
same  year, — all  these  things  and  many  others,  culmi- 
nating in  the  assembling  of  the  first  Continental  Congress 
on  September  5,  1774.  The  next  year  came  Lexington 
and  Bunker  Hill,  precipitating  war. 

Of  France,  the  other  country  with  which  we  were  most 

103 


I04  MEDICINE    IN   AMERICA. 

immediately  concerned,  one  remembers  that  the  amiable 
and  unfortunate  Louis  XVI.  succeeded  Louis  XV.  in 
1774;  and  that,  after  Lafayette  and  many  other  enthu- 
siasts had  joined  the  Americans,  the  king,  for  reasons  of 
policy,  saw  fit  to  arrange  an  alliance  between  France  and 
the  revolted  colonies  in  1778. 

Now,  the  physicians  and  men  of  science  who  made 
memorable  the  eighteenth  century  in  Europe  are  too  nu- 
merous for  individual  mention  here,  but  we  must  give 
them  a  passing  glance. 

The  Englishman  Cheselden  adorned  the  first  half  of 
the  century,  dying  in  1752.  He  taught  some  of  our  Ameri- 
cans, as  did  the  three  Alexander  Munros,  of  Edinburgh, 
the  eldest  of  whom  died  in  1767, — all  anatomists  and 
surgeons. 

Probably  the  ablest  English  surgical  clinician  of  the 
century  was  Percival  Pott,  who  died  in  1787,  the  friend 
and  preceptor  of  our  own  John  Jones. 

The  famous  Hunter  brothers,  of  London,  whose  years 
run  from  1718  to  1793,  made  the  greatest  impress  on 
their  times;  most  of  all  John,  the  younger.  One  must 
remember  of  him  that  more  than  all  others  he  saw  science 
as  we  moderns  see  it;  that  he  sought  the  truth  earnestly 
throughout  his  professional  life,  accepting  nothing  with- 
out proof;  and  that  after  the  lapse  of  more  than  a  cen- 
tury the  English-speaking  world  looks  back  to  him  as 
the  most  dignified  and  commanding  figure  in  our  annals  of 
surgical  science  because  he  made  possible  that  science  as 
it  is. 

On  the  Continent,  Haller,  of  Berne,  is  the  great  name 
for  us.  Of  tireless  energy,  enormous  capacity  for  work, 
broadly  educated,  with  a  constant  love  of  science  and  an 
unusual  grasp  of  its  meaning,  he  rose  to  eminence  as  an 
anatomist,  surgeon,  and  physiologist,  and  came  to  be 
regarded  as  the  father  of  that  last  great  branch  of  our 
work. 


THE   REVOLUTION.  105 

Then  there  were  Sommering,  of  Frankfort;  Winslow, 
of  Paris ;  and  Morgagni,  of  Venice,  the  founder  of  patho- 
logical anatomy  as  a  science. 

These  are  a  few  of  them;  and  they  interest  us  more 
directly  because  they  dominated  that  old  medical  world, 
they  were  sought  out  by  our  Joneses,  Bards,  Morgans, 
and  Shippens,  and  so  their  work  and  their  teaching 
were  coming  in  some  fashion  to  the  knowledge  of  our 
American  doctors  about  the  time  of  the  Revolutionary 
War. 


CHAPTER    V. 

THE  EIGHTEENTH   CENTURY.      THE  REVOLUTION. 

In  the  foregoing  chapters  we  have  seen  something  of 
the  planting  of  medical  science  in  the  New  World  and 
the  type  of  men  who  brought  it  hither.  At  first  it  com- 
pared not  unfavorably  with  what  was  known  and  prac- 
tised in  Europe,  for  many  of  the  pioneer  doctors  were 
educated  men  and  others  returned  to  the  old  countries 
for  their  training.  As  that  early  generation  died  out, 
however,  there  came  a  decline  in  the  standard  of  excel- 
lence, and,  save  for  the  foreigners  who  found  their  way 
to  these  shores  and  a  few  wiser  ones  of  our  own,  the 
medical  attainments  of  our  ancestors  were  not  high.  This 
was  to  be  expected  from  a  lack  of  schools  in  the  colonies, 
as  we  have  seen;  and  only  with  the  rise  of  the  schools 
and  the  spreading  abroad  of  a  higher  learning  was  the 
remedy  slowly  found. 

So  it  came  about  that  in  the  war  of  the  American 
Revolution  American  surgery  played  but  a  sorry  part. 
Some  exceptions  there  were:  Jones  and  Bard,  Mor- 
gan and  Warren,  and  a  few  others;  but  mostly  the  ser- 
vices rendered  the  troops  were  scandalously  crude  and  on 
a  par  with  much  that  was  feebly  and  foolishly  done  in 
other  departments  of  the  public  service. 

When  we  come  to  consider  men  and  measures  in  the 
surgery  of  our  Revolution,  these  names  stand  out  con- 
spicuously,— all  Philadelphians :  ]\Iorgan,  Shippen,  and 
Rush;  the  two  former  physicians-in-chief  of  the  army, 
the  last  prominent  in  affairs  of  state  and  a  prolific  writer 
and  missionary  in  affairs  medical.  And  the  conspicuous 
fact  about  the  personnel  of  the  medical  department  was 
io6 


THE   REVOLUTION.  107 

the  apparent  sharp  Hne  of  cleavage  between  the  officers 
of  the  general  hospital  (who  seem  to  have  been  well- 
qualified,  faithful  men,  too  few  in  numbers)  and  the  regi- 
mental surgeons,  their  subordinates  in  rank  and  notably 
their  inferiors  in  equipment,  in  efficiency,  in  fidelity,  and 
in  morale. 

As  we  can  divide  the  surgeons  of  the  Revolution  into 
two  classes,  so,  for  the  sake  of  convenience,  may  we  divide 
the  surgical  events  of  the  war  into  two  eras :  the  first 
when  John  Morgan  was  director-general  and  chief  phy- 
sician of  the  army;  the  second  when  William  Shippen, 
Jr.,  held  the  same  office.  There  were  other  chief  physi- 
cians: Benjamin  Church  for  a  few  months  after  Lexing- 
ton, and  John  Cochran  for  a  few  months  towards  the  end 
of  the  war;  but  Morgan  and  Shippen  are  the  most  con- 
spicuous names. 

Although  the  chiefs  of  the  medical  department  were 
Philadelphians,  that  city  did  not  furnish  its  proportionate 
number  of  surgeons  for  the  war;  indeed,  so  far  as  one 
may  judge  from  available  writings,  the  greatest  number 
of  surgeons  came  from  the  neighborhood  where  the  initial 
fighting  took  place.  Except  a  few  prominent  Tory  phy- 
sicians resident  in  Boston,  nearly  all  the  active  and  promi- 
nent contemporary  doctors  of  Massachusetts  first  or  last 
took  service  with  the  armies,  and  in  the  Massachusetts 
Provincial  Congress  of  1774- 1775  there  were  twenty-two 
physicians.^ 


^Joseph  Batchelder,  of  Grafton,  Worcester  County;  William  Bay- 
liss,  of  Dighton,  Bristol  County;  Chauncey  Brewer,  of  West  Spring- 
field, Hampshire  County;  Alexander  Campbell,  of  Oxford,  Worces- 
ter County;  Benjamin  Church,  of  Boston;  David  Cobb,  of  Taunton, 
Bristol  County;  William  Dunsmore,  of  Lancaster,  Worcester 
County ;  John  Corbet,  of  Bellingham,  Suffolk  County ;  Isaac  Foster, 
of  Charlestown,  Middlesex  County;  Ephraim  Guiteau,  of  New  Marl- 
borough, Berkshire  County;  Jeremiah  Hall,  of  Pembroke,  Plymouth 
County;  James  Hawse,  of  Westborough,  Worcester  County; 
Samuel  Holten,  of  Danvers,  Essex  County;  William  Jamieson,  of 
Meriden,  Worcester  County;    David  Jones,  of  Abington,  Plymouth 


To8  MEDICINE    IN    AMERICA. 

At  the  beginning  of  the  war  there  was  no  general 
mihtary  organization,  even  in  name,  much  less  a  depart- 
ment of  surgery,  and,  as  one  might  expect,  the  building 
up  of  so  complex  a  department  was  a  difficult  and  tedious 
task.  Mostly,  the  colonies  were  ill  equipped  with  com- 
petent medical  men;  although,  fortunately,  there  were 
some  few  brilliant  exceptions,  whose  experience  em- 
braced not  only  an  acquaintance  with  European  surgery 
but  a  considerable  army  service  in  the  French  and  Indian 
wars. 

Every  reader  is  familiar  with  the  disheartening  diffi- 
culties with  which  Washington  struggled  for  years  in  his 
commissary  and  equipment  departments,  the  needs  of 
which  could  be  made  evident  to  the  dullest  minds;  but 
those  difficulties  were  trifling  compared  with  the  trials  of 
the  medical  department. 

From  the  very  outset  every  variety  of  supplies  was 
scanty  or  entirely  lacking.  Instruments  were  few,  and 
the  makers  were  too  busy  turning  out  guns  and  swords 
to  supply  the  need.  Drugs  were  few,  bad,  and  of  small 
variety.  Hospitals  and  hospital  corps  had  to  be  created ; 
hospital  supplies  were  not  to  be  had.  Opium  and  quinine 
were  scarcely  to  be  found ;  ether  was  unknown.  The  one 
disease  which  was  successfully  combated  was  smallpox, 
for  which  inoculation  was  practised,  and  constantly 
throughout  the  war  whole  army  corps  submitted  to  this 
operation. 

Fortunately,  although  the  Continental  Congress  had 
been  able  to  provide  and  prepare  for  none  of  these  things, 
the  various  colonies  had  in  some  fashion  anticipated  such 
needs, — most  indifferently,  to  be  sure;  and  the  best- 
County;  Moses  Morse,  of  Worthington,  Hampshire  County;  Rich- 
ard Perkins,  of  Bridgewater,  Plymouth  County;  Charles  Pynchon, 
of  Springfield,  Hampshire  County;  Ebenezer  Sawyer,  of  Wells. 
York  County;  John  Taylor,  of  Summerburg,  Worcester  County; 
Joseph  Warren,  of  Boston ;  William  Whitney,  of  the  towns  of 
Egmont  and  Alfred  in  Berkshire  County. 


THE   REVOLUTION.  109 

equipped  of  them  all,  as  it  was  the  first  one  to  be  forced 
into  the  field,  was  the  colony  of  Massachusetts. 

When  one  attempts  to  unravel  the  rather  confusing 
and  unsatisfactory  accounts  of  medicine  at  the  outbreak 
of  the  war,  one  finds  that  all  roads  lead  to  Bunker  Hill, 
and  that  it  is  there  and  in  the  neighboring  camp  at  Cam- 
bridge that  all  the  interest  centres.  So  when  we  look  for 
the  early  conspicuous  names,  we  find  there  two  which 
come  at  once  to  the  front, — Church  and  Warren. 

Warren — there  were  two  of  them,  Joseph  and  John — 
came  to  be  the  better  known,  and  the  elder,  Joseph,  in  his 
short  life  and  brief  military  experience  so  impressed  men's 
imaginations  that  for  more  than  a  hundred  years  his  name 
has  been  in  the  mouth  of  every  school-boy.  But  it  is  as  a 
soldier  and  patriot  that  he  is  best  known  to  us,  and  for 
our  purposes  he  must  be  passed  briefly. 

Of  all  the  Massachusetts  men  of  the  day, — and  they 
were  many  and  able, — Warren  is,  for  a  brief  space,  the 
most  luminous  figure.  Meteor-like,  as  it  were,  he  flashes 
out  in  the  Old- World  tale :  a  social  lion  become  a  patriot, 
a  young  doctor  turned  orator. 

There  was  much  in  him  to  excite  instant  admiration. 
He  was  thirty-five  years  old,  handsome,  accomplished,  a 
good  fellow,  a  genial  companion,  talented,  successful,  gen- 
erous. Forward  in  the  patriot  movement,  he  proved  him- 
self a  brilliant  and  persuasive  orator :  a  thorn  in  the  side 
of  the  English  authorities,  a  hero  to  his  American  friends. 
It  was  he  who  started  Paul  Revere  on  his  famous  ride, 
and  he  was  one  of  the  first  to  forsake  home  and  practice 
to  hasten  to  the  side  of  the  yeomen  at  the  famous  Lexing- 
ton fight. 

After  that,  and  while  the  Provincial  army  was  closing 
in  about  Boston,  he  was  incessant  in  military  activity.  He 
had  been  elected  President  of  the  Provincial  Congress, 
and  three  days  before  Bunker  Hill  he  was  appointed 
major-general  of  the  colony's  forces.    Previous  to  this  he 


no  MEDICINE    IN    AMERICA. 

had  been  requested  to  take  the  office  of  physician-general 
to  the  army,  but  dechned,  preferring  active  service  in  the 
field. 

So  we  see  him,  pre-eminent  in  position,  in  influence,  a 
perfected  product  of  his  time,  ripe  for  the  great  work 
w^hich  lay  before  our  people,  whether  in  the  senate,  the 
hospital,  or  the  field.  Then  cam.e  the  17th  of  June  and 
the  battle  of  Bunker  Hill. 

Just  how  Warren  came  to  be  an  actor  on  that  famous 
day  must  always  be  a  matter  of  some  doubt.  The  assigned 
troops  under  Prescott  had  taken  position  overnight  on  the 
hills  behind  Charlestown,  overlooking  Boston  and  the 
upper  harbor,  and  the  attack  by  the  British  had  already 
begun  when  Warren  appeared  on  the  field.  I  need  not 
rehearse  the  familiar  tale.  With  characteristic  courtesy 
he  declined  the  command  offered  him  b}^  Prescott,  and, 
taking  a  musket,  volunteered  in  the  ranks.  Certainly  a 
most  irregular  proceeding ;  but  one  wonders  now  whether 
that  spirit,  that  example  of  self-sacrifice,  that  readi- 
ness to  share  the  common  lot,  have  not,  in  the  light  of 
history,  wrought  more  for  honest  patriotism  and  for  the 
advancement  of  true  democrac)^  than  any  parading  of  gold 
lace,  or  high-sounding  etiquette,  or  the  commanding  of 
cohorts,  or  much  talking  in  public  halls.  At  any  rate, 
that  day  saw  the  end  of  ^^^arren  and  all  that  he  might 
famously  have  done.  He  stood  in  the  ranks  through  the 
fight,  he  did  his  duty  modestly  as  he  saw  it,  he  used  his 
ancient  gun  until  he  could  use  it  no  longer,  and  then,  with 
powder  exhausted,  comrades  fleeing,  and  the  English 
rushing  in,  he  was  shot  dead,  among  the  last  at  his  post. 

It  is  a  not  unpleasing  tale,  as  one  digs  it  out  of  the 
records,  old  and  new.  The  life  was  a  full  one ;  it  was  well 
worth  the  living,  and  the  man  comes  down  to  us  a  very 
real  figure,  towering  calm  and  fine  amid  all  the  men  who 
crowd  the  pages  of  our  history. 

Now,  John  Warren,  the  brother,  concerns  this  narra- 


THE   REVOLUTION.  iii 

tive  more  immediately  than  does  his  famous  elder,  but 
his  youth  and  the  purposes  of  his  life  brought  him  less 
conspicuously  before  the  public ;  and  though  early  in  the 
service  of  his  country  and  constant  to  her  interests,  his 
great  reputation  was  made  in  later  and  more  peaceful 
times.  In  the  early  years  of  the  war,  indeed,  he  was  en- 
grossed with  continual  and  various  activities.  The  tale 
of  his  life  has  been  fully  told  us  by  his  son,^  and  illus- 
trates briefly  the  sort  of  times  those  were  in  the  medical 
department  of  our  army  and  the  sort  of  men  who  came 
to  do  the  work. 

John  Warren  was  twelve  years  the  junior  of  his  brother 
Joseph,  under  whom  he  had  studied  medicine,  and  he  had 
been  settled  in  practice  one  year,  in  Salem,  Massachusetts,^ 
when  the  Revolution  came. 

As  we  know,  the  New  England  militia  was  in  a  fashion 
organized,  and  Warren  had  been  for  some  months  on  the 
roster  as  surgeon  to  Colonel  Pickering's  regiment.  He 
went  with  his  command  to  Cambridge,  after  Lexington, 
and,  with  a  brief  interval  of  absence,  remained  three  years 
with  the  army.  He  was  there  when  the  Provincial  troops 
were  turned  over  to  Washington,  and  he  took  part  in  the 
reorganization  of  the  department  when  the  Continental 
Congress  assumed  charge  of  the  affairs  of  the  army.  Even 
before  this  the  Massachusetts  authorities  had  made  an 
endeavor  to  improve  the  personnel  of  the  medical  corps, 
for  on  May  8  they  had  appointed  a  committee  to  examine 
candidates  for  the  positions  of  surgeons  and  surgeons' 
mates. 

Good  James  Thacher,  the  familiar  author  of  the 
"  American  Medical  Biography"  and  "  Military  Journal," 


'The  Life  of  John  Warren,  M.D.,  by  Edward  Warren,  M.D., 
Boston,  1874. 

'  Edward  Augustus  Holyoke,  aged  fifty-six,  was  his  only  important 
competitor  there ;  but  Holyoke  lived  forty-five  years  longer,  and 
died  at  the  age  of  one  hundred  and  one. 


112  MEDICINE    IN    AMERICA. 

was  a  successful  candidate  in  the  June  following,  and  be- 
came \\'arren's  surgeon's  mate,  Warren  himself  having 
been  made  director-general  of  the  hospital.  That  "  Mili- 
tary Journal'"  is  most  instructive  and  entertaining  reading. 
Take  it  in  connection  with  Moore's  "  Diar}^  of  the  Ameri- 
can Revolution,''  and  you  will  get  a  rarely  luminous 
picture  of  the  times. 

It  is  the  unanimous  statement  of  writers  on  the  medical 
conditions  in  the  army  that,  with  the  exception  of  Massa- 
chusetts, the  colonies  neglected  shamefully  the  care  of 
their  own  sick  and  wounded.  The  regimental  surgeons 
were  named  generally  by  the  colonels  (who  disregarded 
professional  attainments),  and  frequently  some  personal 
friend  or  political  favorite  received  the  appointment. 
Some  regiments  came  into  camp  without  any  surgeon 
whatever.  From  first  to  last,  as  we  have  seen,  supplies 
w'ere  lacking,  and  the  regimental  surgeons  —  inexperi- 
enced, inexpert,  slighted,  neglected,  and  harried — became 
shortly  an  almost  mutinous  band  of  independent  and  dis- 
organized men. 

It  would  be  pleasant  to  believe  and  gracious  to  say  that 
they  were,  as  a  class,  competent,  devoted,  and  patriotic; 
but  the  facts  of  history,  in  spite  of  the  generalizings  of 
prejudiced  writers,  do  not  bear  out  any  such  claim.  Yet 
one  cannot  especially  blame  those  men.  They  were  the 
average  of  their  kind.  Their  incompetence  was  due  to  a 
lack  of  education  in  medicine,  and  such  training  as  they 
had  was  for  civil  life.  They  were  selected  at  random, 
they  received  little  supervision,  direction,  countenance,  or 
advice,  and  the  demands  made  upon  their  time  and  skill 
were  usually  beyond  the  bounds  of  reason. 

Late  in  1775,  indeed.  Congress  took  hold  of  the  prob- 
lem feebly,  haltingly,  and  with  little  wisdom;  there  was 
some  improvement,  but  not  much.  The  faults  were  those 
of  an  undisciplined  democracy,  and  have  not  been  un- 
known in  American  wars  of  modern  times.    Even  in  1776. 


THE    REVOLUTION.  113 

after  a  year  of  experience,  Congress  made  some  such  pro- 
visions as  these :  that  there  should  be  one  surgeon  and  five 
mates  to  every  five  thousand  enhsted  men;  that  special 
orderlies  should  from  time  to  time  be  appointed ;  that  the 
outfits  of  regimental  surgeons  should  be  subject  to  inspec- 
tion by  the  hospital  director  and  director-general;  that 
reports  should  be  made  regularly;  and  that  the  expense 
of  supplies  should  be  met  by  the  department  director. 

The  hospital  surgeons  were  to  be  paid  one  dollar  and 
sixty-six  cents  a  day,  the  mates  one  dollar,  the  hospital 
apothecary  one  dollar  and  sixty-six  cents  a  day,  and  the 
hospital  surgeons  and  mates  were  to  take  rank  of  regi- 
mental surgeons  and  mates  (assistant  surgeons).  All  of 
which  is  interesting,  pathetic,  and  significant  of  the  uni- 
versal poverty.  Fancy  six  physicians  intrusted  v/ith  the 
care  of  more  than  five  thousand  men  in  the  campaigns  of 
to-day.  And  their  pay  was  less  than  what  we  now  give  to 
unskilled  labor  in  the  streets. 

One  thing  the  regulations  provided :  the  proper  rank- 
ing of  hospital  and  regimental  surgeons.  The  neglect  of 
this  had  long  been  a  source  of  serious  trouble,  and  the 
settling  of  the  vexed  question  made  for  an  improved 
discipline. 

After  the  arrival  of  Washington  at  Cambridge,  early 
in  July,  some  degree  of  order  and  discipline  began  to  pre- 
vail in  the  medical  branch  of  the  service,  as  in  the  other 
departments.  But  the  material  he  found  to  hand  and  his 
dependence  upon  the  action  of  the  Congress  gravely  ham- 
pered him.  Fortunately,  the  colonials  were  confronting 
an  inactive  enemy,  so  that,  beyond  camp  fevers  and  small- 
pox, the  surgeons  found  little  occasion  for  their  skill.  One 
would  suppose  that  they  might  have  employed  their  time 
in  the  perfecting  of  camp  sanitation,  the  drilling  of  ambu- 
lance corps,  and  many  other  such  essentials;  but  even  in 
the  best-equipped  armies  of  Europe  such  details  were  little 
regarded,  and  the  English,  who  taught  us  what  little  we 


114 


MEDICINE    IN    AMERICA. 


knew,  had  at  that  time  long  been  under  a  lax  and  stupid 
discipline,  caring  little  for  the  science  of  the  military 
calling. 

Warren,  who  was  but  twenty-three  years  old,  proved 
himself  a  zealous  and  intelligent  officer  in  such  w-ork  as 
was  done.  He  attended  strictly  to  his  duties,  organized 
his  hospital,  trained  his  assistants,  kept  up  a  constant  de- 
mand for  further  supplies,  cared  for  the  sick,  sought  to  im- 
prove the  morale  of  his  fellows,  and,  as  his  assistant 
Thacher  wrote,  "  acquired  a  great  reputation  in  his  pro- 
fession, .  .  .  distinguished  for  his  humanity  and  atten- 
tion to  the  sick  and  wounded  soldiers  and  for  his  humane 
disposition."  He  came,  indeed,  to  win  the  confidence  of 
his  superiors,  and  before  the  evacuation  of  Boston,  in 
1776,  M^as  looked  upon  as  a  young  man  who  would  be 
heard  from  later. 

The  departure  of  the  British  from  Boston  and  the  re- 
moval of  the  American  army  to  other  scenes  opened  for 
the  medical  department  new  and  untried  fields,  and 
Warren  shared  their  pains.  From  that  time  on,  except 
when  resident  in  winter-quarters,  the  surgeons  had  con- 
stant experience  of  active  campaigning,  and  their  slender 
resources  were  stretched  constantly  to  breaking. 

In  May,  1776,  Warren  was  in  New  York,  fighting  the 
dysentery  which  was  affecting  the  troops,  and  for  three 
months  he  was  fully  occupied  in  helping  to  bring  his  men 
into  condition  for  the  engagement  which  the  whole  coun- 
try knew  to  be  impending. 

Of  course  the  holding  of  New  York  City  without  a 
fleet  or  proper  ordnance  A^as  an  impossibility,  but  Wash- 
ington feared  the  moral  effect  on  the  soldiers  and  on  the 
country  which  would  result  from  evacuating  the  place 
without  fighting;  consequently  he  planned  and  failed  in 
the  Long  Island  campaign  in  August  of  that  year.  Mas- 
terly retreat,  evacuation,  further  retreat,  and  a  series  of 
small  engagements  followed,  with  all  of  which  we  have 


THE    REVOLUTION.  115 

little  to  do,  except  to  note  this,  that  in  some  fashion  hos- 
pitals were  established  and  shifted  about  as  occasion  de- 
manded, and  that  just  before  the  battle  of  Long  Island 
Warren  received  the  often-quoted  razor  letter  from 
Director-General  John  Morgan : 

"  Sir, — I  have  sent  to  the  surgeons,  desiring  the 
youngest  off  duty  to  go  to  your  assistance  and  take  four 
mates  with  him;  to  carry  over  500  additional  bandages 
and  twelve  fracture  boxes.  I  fear  they  have  no  scalpels 
as  whatever  I  have  committed  to  the  hospitals  has  always 
been  lost.  I  send  you  two,  in  which  case  if  you  want 
more,  use  a  razor  for  an  incision  knife.  Let  me  know 
from  time  to  time,  at  Long  Island. 

"  J.  Morgan. 

"  To  Dr.  Warren,  surgeon  of  the  General  Hospital  at 
Long  Island." 

And  be  it  remarked  that  a  razor  is  no  mean  instru- 
ment. 

We  need  not  follow  this  young  Warren  further  in  his 
army  career.  He  has  served,  perhaps,  to  illustrate  the  best 
men  of  his  class.  His  active  campaigning  lasted  another 
year ;  then  he  was  stationed  at  the  army  hospital  in  Bos- 
ton, and  so  passed  gradually  back  to  civil  life,  to  be  heard 
of  later,  as  we  shall  see. 

Now,  John  Warren  was  but  one  of  very  many  the 
recital  of  whose  names  and  deeds  would  mean  a  great  his- 
tory of  the  war,  and  have  they  not  mostly  been  enumer- 
ated of  late  by  another  ?  ^  There  are,  however,  some  few 
in  the  various  colonies  whom  it  would  be  invidious  to 
neglect.  Among  them  John  Brooks,  of  Medford,  Mas- 
sachusetts, came  to  be  well  known. 


*  History  of  Medicine  in  the  United   States,  by  F.   R.    Packard, 
M.D.,  p.  233  et  seq. 


ii6  MEDICINE    IN   AMERICA. 

He  was  born  in  1752,  the  year  before  John  Warren,  and 
began  his  career  by  going  to  school  with  the  boy  who  was 
known  later  as  Count  Rumford.  A  year  or  two  before 
the  war  he  began  to  practise,  but  dropped  that  work 
with  the  outbreak  of  fighting  and  served  through  to  the 
end  as  a  combatant.  He  was  at  Saratoga  as  colonel  and  at 
JMonmouth  as  adjutant-general.  Then,  with  the  return  of 
peace,  he  took  up  his  profession  again,  making  a  name 
for  himself  at  that.  He  found  time  for  politics,  was  con- 
spicuous in  State  affairs,  was  governor  in  18 16,  and  dis- 
tinguished in  office.  Altogether  it  was  a  notable  life  and 
would  well  repay  the  telling. 

Besides,  one  must  record  the  early  volunteers,  Aspin- 
wall,  Cumming,  Dexter,  Downer,  Minot,  Prescott,  Welch, 
with  Eustis,  Thacher,  Homans,  and  dozens  of  lesser  note. 

It  was  in  that  first  year  of  the  war  that  one  saw  Mas- 
sachusetts folk  rise  almost  to  a  man,  carrying  the  doctors 
with  them;  but  later,  when  time  brought  weariness,  de- 
feat, and  hardship,  recruits  were  less  eager,  and  with  the 
removal  of  the  armies  to  other  scenes  the  doctors,  like  the 
others,  came  slowly  to  the  front. 

Josiah  Bartlett  was  Massachusetts  born,  in  1729,  and 
practised  medicine  in  New  Hampshire.  He  was  a  colonel 
of  militia,  then  a  member  of  the  Continental  Congress, 
and  signed  the  Declaration  of  Independence.  After  the 
war  he  was  a  Superior  Court  justice  and  governor  of  the 
State. 

Another  New  Hampshire  doctor,  Matthew  Thornton, 
an  Irishman  born,  was  also  a  signer  of  the  Declaration. 

Jonathan  Arnold,  of  Rhode  Island,  was  a  doctor.  Con- 
gressman, and  Senator.  Oliver  Wolcott,  of  Connecticut, 
was  a  doctor,  Congressman,  signer  of  the  Declaration, 
major-general,  and  governor. 

Of  New  York  doctors  we  hear  little,  and,  with  the  ex- 
ception of  Morgan,  William  Shippen,  Jr.,  and  Rush,  the 
same  is  true  of  Pennsylvania. 


THE   REVOLUTION.  117 

The  last  named  will  be  heard  from  later.  Suffice  it  now 
that  he  signed  the  Declaration  of  Independence  and  proved 
of  service  to  the  hospital  department  of  the  army. 

From  Virginia  came  Hugh  Mercer,  Washington's 
friend,  a  Scotchman,  and  in  youth  a  follower  of  the  young 
Pretender.  He  went  into  our  war  as  a  volunteer,  and 
Congress  made  him  a  brigadier-general.  He  was  killed 
at  Princeton  in  1777. 

North  Carolina  furnished,  among  others,  Nathaniel 
Alexander,  a  successful  physician  and  army  surgeon,  and 
later  governor  of  the  State. 

Probably  the  best-known  physician  from  the  South  was 
David  Ramsay,  of  South  Carolina.  He  was  also  an  his- 
torian and  a  statesman.  And  there  are  a  great  many 
others  enumerated  by  Packard,  from  whom  I  have  taken 
these  few  facts. 

So  we  have  made  mention  of  these  lesser  men,  noting 
them  and  their  work.  But  there  remain  those  others,  high 
in  rank,  though  unequal  in  fame,  our  first  surgeons- 
general. 

Benjamin  Church,  of  Boston,  was  the  first  surgeon- 
general  of  the  American  army.  The  Continental  Con- 
gress took  in  hand  the  question  of  medical  organization 
about  a  month  after  the  battle  of  Bunker  Hill,  and  ap- 
pointed a  committee  to  consider  the  matter.  At  first  the 
whole  medical  service  was  called  the  "  Hospital,"  and  it 
was  only  later  in  the  war  that  this  all-embracing  term 
fell  into  disuse  and  the  custom  was  adopted  of  separating 
the  hospital  service  and  the  regimental  service,  the  former 
ranking  the  latter.  The  head  of  the  department  was  given 
the  title  "  Director-General  and  Chief  Physician,"  and  his 
pay  was  four  dollars  a  day. 

The  duties  of  the  director-general  were  strictly  limited. 
He  was  "  to  furnish  medicines,  bedding  and  all  other 
necessaries,  to  pay  for  the  same,  superintend  the  whole, 
and  make  his  report  to,  and  receive  orders  from,  the  com- 


ii8  MEDICINE   IN   AMERICA. 

mander-in-chief."  He  was  also  to  appoint  four  surgeons, 
— one  to  every  five  thousand  men, — and  each  of  these 
surgeons  was  to  have  five  mates,  as  we  have  heard.  This 
number  assumed  an  army  of  twenty  thousand  men. 

It  is  hard  to  learn  much  about  Church.  The  appoint- 
ment seems  to  have  been  obvious  and  proper.  He  was 
a  leader  of  the  profession  in  Boston,  reputed  an  ardent 
patriot,  closely  associated  with  the  men  who  were  direct- 
ing affairs  in  Massachusetts,  and  was  the  natural  medical 
head  of  an  army  composed  largely  of  New  England  men. 

At  the  time  of  Lexington  he  was  about  forty  years  old, 
in  the  full  tide  of  an  eminently  successful  practice;  and 
Thacher  tells  us  that  "  as  a  skilful  and  dexterous  operator 
in  surgery  he  was  inferior  to  no  one  of  his  contemporaries 
in  New  England."  Church  was  of  a  rather  difficult  age 
as  respected  his  leanings  in  political  matters,  and  that  be- 
cause he  was  placed  midway  between  the  older  and  the 
younger  generations  of  the  profession.  Most  of  the  older 
men  were  Tories,  most  of  the  younger  men  were  Whigs, 
and  as  his  connections  and  intimacies  lay  with  both,  he 
was  drawn  both  ways.  However,  his  patriotism  seems 
never  to  have  been  doubted,  for  he  was  constantly  out- 
spoken and  active  on  the  side  of  the  colonies,  and  was  one 
of  the  very  first  to  volunteer  his  services  at  the  outbreak 
of  hostilities.  He  was  at  the  same  time  an  influential 
member  of  the  Provincial  Congress,  and  in  July,  1775, 
was  appointed  physician-in-chief  of  the  Continental  army. 

For  a  few  weeks  Church  seems  to  have  proved  himself 
an  able  and  successful  administrator  of  his  department. 
Proper  equipment  for  the  hospitals  was  inaugurated,  the 
regimental  surgeons  were  inspected  and  instructed,  and 
it  seemed  as  though,  in  this  case  as  in  others,  Massachu- 
setts had  produced  the  proper  man ;  when,  to  the  conster- 
nation of  his  friends  and  the  indignation  of  the  army,  he 
was  detected  in  correspondence  with  the  enemy. 

The  facts  in  regard  to  this  first  famous  charge  of  trea- 


THE    REVOLUTION.  119 

son  will  probably  never  be  known.  Indeed,  Church  seems 
to  have  been  treated  with  remarkable  clemency.  The 
evidence  against  him  rested  upon  an  intercepted  cipher 
letter  to  a  friend  in  Boston,  and  when  the  cipher  came  to 
be  translated  it  appeared,  in  some  fashion,  to  bear  out 
the  author's  claim  that  it  was  an  innocent  stratagem, 
designed  to  secure  information  from  the  enemy.  At  any 
rate,  he  was  arrested,  held  under  guard  for  some  four 
months,  and  then  tried  by  court-martial  and  convicted.^ 

°  Washington  wrote  to  the  Congress, — 

"  I  have  now  a  painful,  though  a  necessary  duty  to  perform, 
respecting  Dr.  Church,  Director  General  of  the  hospital.  About  a 
week  ago  Mr.  Secretary  Ward,  of  Providence,  sent  up  to  me  one 
Wainwood,  an  inhabitant  of  Newport,  with  a  letter  directed  to 
Major  Cane  in  Boston  in  [occult]  characters,  which  he  said  had 
been  left  with  Wainwood  some  time  ago,  by  a  woman  who  was  kept 
by  Dr.  Church.  She  had  before  pressed  Wainwood  to  take  her  to 
Captain  Wallace,  Mr.  Dudley  the  collector,  or  George  Rowe,  which 
he  declined.  She  then  gave  him  a  letter  with  a  strict  charge  to 
deliver  it  to  either  of  those  gentlemen.  He,  suspecting  some  im- 
proper correspondence,  kept  the  letter,  and  some  time  after  opened 
it,  but  not  being  able  to  read  it,  laid  it  up,  where  it  remained  until 
he  received  an  obscure  letter  from  the  woman,  expressing  an  anxiety 
after  the  original  letter.  He  then  communicated  the  whole  matter 
to  Mr.  Ward,  who  sent  him  up  with  the  papers  to  me.  I  immediately 
secured  the  woman,  but  for  a  long  time  she  was  proof  against  every 
threat  and  persuasion  to  discover  the  author.  However,  at  length 
she  was  brought  to  a  confession,  and  named  Dr.  Church.  I  then 
immediately  secured  him  and  all  his  papers.  Upon  his  first  exami- 
nation, he  readily  acknowledged  the  letter;  said  it  was  designed  for 
his  brother  Fleming,  and,  when  deciphered,  would  be  found  to  con- 
tain nothing  criminal.  He  acknowledged  his  never  having  commu- 
nicated the  correspondence  to  any  person  here  but  the  girl ;  and 
made  many  protestations  of  the  purity  of  his  intentions.  Having 
found  a  person  capable  of  deciphering  the  letter,  I,  in  the  mean  time, 
had  all  his  papers  searched,  but  found  nothing  criminal  among  them. 
But  it  appeared  on  inquiry  that  a  confidant  had  been  among  the 
papers  before  my  messenger  arrived.  I  then  called  the  general 
officers  together  for  their  advice — the  result  of  which  you  will  find 
enclosed.  The  deciphered  letter  is  also  enclosed.  The  army  and 
country  are  exceedingly  irritated ;  and,  upon"  a  free  discussion  of  the 
nature,  circumstances  and  consequence  of  this  matter,  it  has  been 
unanimously  agreed  to  lay  it  before  the  honorable  Congress  for 
their  special  advice  and  direction." 


I20  MEDICINE    IN   AMERICA. 

He  seems  to  have  taken  his  trial  with  remarkable  forti- 
tude, and  his  defence  of  his  conduct  proved  a  strong  and 
almost  convincing  document.^  However,  he  w^as  con- 
victed, kept  in  prison  for  a  year,  then  given  his  freedom, 
allow-ed  to  sail  with  his  family  for  the  West  Indies,  and 
was  heard  of  no  more ;  lost  at  sea,  most  probably.  That 
was  the  end  of  him,  and  he  seems  to  have  left  a  minimum 
of  hard  feeling  behind  him.  His  expulsion  from  the  As- 
sembly, w^hich  occurred  immediately  after  the  court- 
martial,  exhausted  that  sentiment.  Warren  and  Thacher, 
his  associates,  refer  casually  to  him ;  Washington  groaned 
in  spirit,  found  a  man  to  take  his  place,  and  the  world 
moved  on. 

It  was  a  far  different  treason  and  catastrophe  from 
that  of  the  contemptible  Arnold  or  the  pathetic  Andre. 

The  man  who  took  Church's  place  was  perhaps  the  most 
eminent  American  physician  of  his  generation  :  John  Mor- 
gan, of  Philadelphia,  of  whom  we  have  heard  before. 

John  Morgan,  the  second  director-general  and  chief 
physician  of  the  American  army,  was  not  a  surgeon.  That 
has  always  been  an  interesting  fact.  He  was  a  professor 
of  medicine  in  the  Philadelphia  school, — a  fine,  w^ell- 
equipped,  "  all  around"  man ;  but  even  he  did  not  succeed 
in  those  grievous  times.  He  struggled  intelligently,  labo- 
riously, and  faithfully  for  the  good  of -the  service,  under 
the  most  trying  circumstances  and  against  impossible  con- 
ditions, for  two  years ;  he  failed  to  satisfy  the  politicians ; 
he  was  dismissed  the  service;  he  prevailed  upon  his  rep- 
resentatives in  Congress  to  have  his  conduct  investigated ; 
he  was  most  honorably  acquitted  of  all  blame,  but  was  not 
reinstated;  he  retired  to  private  life,  a  saddened  man; 
and  he  died  eight  years  after  the  close  of  the  war. 

It  is  a  tale  that  does  no  special  credit  to  our  ancestors. 


'  Massachusetts  Historical  Society's  Collections,  first  series,  vol.  i. 
p.  84. 


THE   REVOLUTION.  121 

The  types  of  men  of  many  callings  and  the  qualities  of 
their  service  in  the  Revolution  and  in  later  American  wars 
are  in  striking  contrast.  In  that  ancient  struggle  all  that 
was  best  in  the  country  came  at  once  to  the  front.  While 
in  1774  and  the  immediately  succeeding  years  the  highest 
talent  of  the  country  was  in  Congress  passing  those  re- 
markable resolutions  which  have  become  national  classics 
and  drafting  the  famous  Declaration,  later  years  saw  the 
best  of  those  same  men  active  in  the  field  or  returned  to  the 
more  practical  and  immediate  service  of  their  States,  until 
the  Congress  shrunk  into  a  relatively  inefficient  and  incom- 
petent body.  So  the  most  eminent  physicians,  even  those 
of  advanced  age,  were  to  be  found  in  field  and  hospital 
as  the  war  progressed.  In  later  wars,  as  we  know,  the 
young  manhood  of  the  country  mostly  entered  the  service, 
while  mature  and  elderly  men  remained  in  the  pursuits  of 
civil  life ;  but  in  the  medical  service  of  the  Revolution  we 
find  active  in  the  field  the  few  eminent  physicians  of  the 
country,  and  civil  practice  left  to  the  lukewarm  and  less 
efficient. 

Morgan  was  the  most  prominent  medical  teacher  in  the 
land,  and  we  find  him  at  the  front.  There  also  were  Wil- 
liam Shippen,  Jr.,  and  Bard  and  Jones.  The  medical 
schools  were  practically  closed — that  in  New  York  per- 
force— and  medical  education  nearly  ceased  throughout 
the  land.  Rarely  in  modern  history,  except,  perhaps,  in 
the  Southern  States  during  the  Civil  War,  have  the  pur- 
suits of  peace  been  so  universally  abandoned. 

Morgan  was  appointed  director-general  in  October, 
1775,  and  entered  at  once  and  vigorously  upon  his  duties. 
The  advantage  of  his  experience  in  the  old  French  War 
was  apparent,  for  the  service  began  to  show  improvement 
in  morale  and  personnel.  Especially  he  saw  to  it  that 
medical  officers  passed  rigid  examinations  before  being 
commissioned ;  his  oversight  was  constant  and  for  a  time 


122  MEDICINE    IN   AMERICA. 

efficient.  All  this  Avas  possible  enough  while  the  head- 
quarters was  stationary,  the  main  army  in  camp  before 
Boston,  and  the  main  body  of  the  enemy  inactive;  but 
with  a  change  in  these  conditions  came  discouragement 
and  partial  failure.  It  was  possible  to  secure  some  much- 
needed  supplies  for  the  army  in  New  England,  it  was  pos- 
sible to  supervise  and  discipline  his  subordinates,  it  was 
possible  even  to  discharge  the  inefficient ;  but  when  it  came 
to  operating  over  widely  separated  regions,  when  disaster 
overtook  American  arms,  when  desertions,  discontent,  in- 
subordination, and  even  treachery  appeared  in  the  ranks, 
and  the  distant,  almost  independent,  corps  were  beyond 
vision  and  control;  when  supplies  failed,  when  the  sick- 
list  increased,  when  winter  came  and  gloom  overspread  the 
land,  then,  indeed,  there  was  found  but  one  man,  stead- 
fast, patient,  imperturbable, — the  Commander-in-Chief; 
and  Morgan  was  not  a  Washington. 

Besides  constant,  untiring,  but  nearly  ineffective  efforts 
to  obtain  supplies  from  the  Congress,  Morgan  succeeded 
in  securing  the  proper  ranking  of  hospital  and  regimental 
surgeons,  making  the  latter  subordinate  to  the  former. 
For  this  reason  the  aggrieved  men  entertained  for  him  a 
constant  hatred  which  led  eventually  to  open  hostility  and 
his  dismissal.  Meantime  he  did  his  best  to  allay  their 
indignation ;  he  treated  them  with  constant  fairness,  and 
sought  by  conference  and  discussion  to  adjust  the  dif- 
ferences. 

So  early  as  July  17,  1776,  before  the  retreat  from  Long 
Island,  he  agreed  with  them  upon  a  code  of  rules,  and 
transmitted  the  copy  to  the  Congress ;  but  that  body  failed 
to  act  upon  it.  Instead  there  was  adopted  a  system 
which  Morgan  had  proposed  and  submitted  some  months 
previously.  The  later  convention  was  intended  to  super- 
sede this,  but  the  disregard  of  it  by  the  Congress  roused 
again  the  indignation  of  the  surgeons,  and  Morgan  was 
believed  to  have  played  them  false.     The  subject-matter 


THE   REVOLUTION.  123 

of  those  newly  adopted  rules  we  have  recorded.  Against 
such  ranking  and  pay  a  bitter  protest  continued. 

So  much  for  the  prime  cause  of  Morgan's  unpopularity. 
There  were  other  causes;  and  the  great  poverty  of  the 
country,  the  wretched  transportation,  and  the  follies  of 
the  Congress  were  made  use  of  by  his  enemies. 

Samuel  Stringer,  of  the  Northern  army,  was  a  bump- 
tious person  and  a  thorn  in  the  flesh.  His  title  was  "  Di- 
rector of  the  Hospital,  and  Chief  Physician  and  Surgeon 
for  the  Army  in  the  Northern  Department."  The  evi- 
dence at  hand  goes  to  show  that  he  was  inefficient;  but 
his  worst  offence  was  that  he  disregarded  his  superior, 
Morgan,  and  communicated  directly  with  the  Congress, 
apparently  with  its  approbation. 

The  story  of  our  Revolution  is  so  full  of  squabbles, 
jealousies,  insubordination,  fickleness,  and  incompetence 
that  one  must  keep  steadfastly  in  mind  the  really  great 
men  who  initiated  it  and  carried  it  through,  and  the  stead- 
fast resolve  of  the  faithful  masses,  if  one  would  appre- 
ciate the  tremendous  significance  of  it  all.  Never  for  one 
moment  did  the  people  lose  confidence  in  Washington,  but 
often  they  were  impatient  and  indignant  with  their  feeble 
Congress  and  with  the  creatures  which  the  Congress  set 
up  and  pulled  down. 

Now,  this  Stringer  was  an  example  of  such.  An 
amiable  and  competent  doctor  in  private  life,  a  friend  of 
Schuyler,  and  respected  in  his  community,  he  was  given 
a  post  of  great  responsibility  and  failed  in  it.  Probably 
the  fault  was  not  so  much  his  as  that  of  the  men  who  put 
him  there.  He  was  too  self-complacent  for  hard  times 
and  harsh  treatment ;  he  took  offence,  grew  peevish,  neg- 
lected his  plain  duty,  disregarded  orders,  and  was  dis- 
missed. 

While  he  was  still  in  the  service,' Morgan  was  good  to 
him ;  he  overlooked  the  insolence  of  a  subordinate's  reports 
sent  over  his  head  to  the  Congress ;  he  helped  the  man  out 


124  MEDICINE    IN   AMERICA. 

with  supplies,  so  far  as  might  be,  and  backed  up  his  de- 
mands when  they  were  sent  in.  Indeed,  both  men  kept 
up  a  very  constant  outcry  for  help  and  met  with  the  usual 
lack  of  response. 

When  reading  of  this  disregard  by  the  Congress,  one 
must  remember  that  all  officers  in  the  field,  from  Wash- 
ington down,  met  with  the  same  treatment,  and  one  is 
indignant,  not  that  demands  were  not  met,  but  that  no 
replies  were  vouchsafed.  It  seems,  however,  that  Stringer 
failed  even  to  take  advantage  of  the  scant  supplies  at  his 
command,  and  spent  much  valuable  time  in  vain  upbraid- 
ings  and  scoldings. 

All  this  was  a  great  trial  to  Morgan,  who  was  earnestly 
doing  his  best  for  all  the  armies.  He  appealed  constantly 
to  the  Congress  to  make  some  definite  settlement  of  the 
question  of  his  authority, — the  true  underlying  cause  of 
most  of  the  inefficiency  in  the  North ;  and  at  last,  late  in 
1776,  that  body  bestirred  itself  so  far  as  to  appoint  a  com- 
mittee of  investigation. 

Early  in  January,  1777,  the  committee  reported,  with 
the  result  that  Stringer  was  dismissed ;  but,  to  the  aston- 
ishment and  indignation  of  the  army,  Morgan  was  dis- 
missed with  him,  and  no  explanations  were  given. 

Even  before  that  the  unhappy  Morgan  had  a  taste  of  the 
ingratitude  of  his  superiors.  In  the  preceding  October, 
soon  after  the  evacuation  of  New  York,  and  while  the 
scattered  American  troops  were  attempting  to  rally  from 
the  great  disaster  of  Long  Island,  and  were  fighting  that 
series  of  discouraging  engagements  which  culminated  in 
the  retreat  through  New  Jersey,  Morgan,  to  his  intense 
chagrin,  was  ordered  to  confine  his  services  to  the  troops 
operating  east  of  the  Hudson  River,  and  his  old  friend 
and  associate,  William  Shippen,  Jr.,  was  appointed  chief 
physician  of  the  armies  to  the  west.  This  meant  much 
more  than  appears  at  first.  East  of  the  Hudson  there 
were  left  few  troops.     The  duty  consisted  chiefly  in  look- 


THE    REVOLUTION.  125 

ing  after  scattered  garrisons  and  hospitals.  We  except 
the  Northern  army  under  Schuyler;  but  there,  as  we 
know,  Morgan's  authority  was  in  dispute.  It  was  all  a 
most  unhappy,  wretched  business;  and  not  least  unfortu- 
nate was  the  resulting  estrangement  which  separated  Mor- 
gan and  Shippen  for  many  years. 

Shippen  entered  upon  his  duties  with  the  main  Western 
army  that  same  October,  and  the  following  January,  on 
Morgan's  dismissal,  was  made  chief  physician  to  all  the 
forces,  including  those  of  the  North. 

Out  of  all  this  trouble  came  one  good  thing :  the  most 
interesting  and  valuable  medical  document  relating  to  the 
Revolution  that  we  have.  Morgan  demanded  a  court  of 
inquiry,  and  his  published  "  Vindication,"  written  for  the 
court,  is  full  of  information  on  the  conduct  of  the  medical 
department. 

The  surgeons  of  the  General  Hospital,  with  whom  Mor- 
gan was  extremely  popular,  were  eagerly  outspoken  in  his 
support ;  but  the  regimental  surgeons,  far  more  numerous 
and  with  what  we  should  call  a  strong  political  "  pull," 
succeeded  in  accomplishing  his  overthrow. 

It  is  hard  to  see  now,  in  review  of  the  evidence,  on  what 
ground  Morgan  could  justly  have  been  dismissed.  It 
was  charged  against  him  that  he  was  partisan,  that  he 
discriminated  against  the  regimental  surgeons  and  regi- 
mental hospitals,  that  he  failed  to  distribute  properly  the 
scanty  supplies  in  hand,  and,  finally  and  most  unwarrant- 
ably, that  he  appropriated  supplies  for  the  benefit  of  his 
own  pocket.  How  much  or  how  little  of  all  this  was 
believed  by  the  Congress  we  cannot  tell;  but  the  most 
charitable  view  of  the  action  of  that  body  is  that  it  was 
convinced  of  grave  dissensions  in  the  department,  due  to 
the  chief's  unpopularity,  and  that  it  removed  him  for  the 
greater  good  of  the  service. 

However  that  may  be,  on  Morgan's  demand,  a  commit- 
tee, acting  as  a  court  of  inquiry,  was  appointed  after  more 


126  MEDICINE    IN    AMERICA. 

than  two  years,  and  on  June  12,  1779,  returned  a  report 
honorably  acquitting  him  of  all  the  charges  against  himJ 

After  his  dismissal,  in  1777,  nothing  remained  for  Mor- 
gan but  to  retire  to  private  life  and  practice.  Indeed, 
the  hardships  of  campaigning  had  proved  almost  too  much 
for  him,  and  he  never  recovered  his  health  or  took  any 
especially  active  part  in  affairs.  After  the  war  he  did 
some  little  medical  teaching,  and  even  became  reconciled 
to  his  old  friend  and  later  enemy,  Shippen,  against  whom 
his  anger  seems  to  have  been  quite  unjustifiable.  But  he 
lived  only  until  1789,  and  died  comparatively  young — 
fifty-four  years  old — and  a  poor  man  at  that. 

It  is  an  interesting  character;  not  great,  certainly,  as 
Washington  was  great;  but  earnest,  highly  intelligent, 
far-seeing,  laborious,  zealous,  faithful.  Sensitive,  too, 
which  he  could  ill  afford  to  be.     Nearly  heart-broken  by 


^ "  Congress  took  into  consideration  the  report  of  the  committee  to 
whom  was  referred  the  Memorial  of  Dr.  John  Morgan,  late  Director- 
General  and  Physician-in-Chief  in  the  General  Hospital  of  the 
United  States,  and  thereupon  came  to  the  following  resolution : 

"  Whereas,  by  the  report  of  the  Medical  Committee  confirmed  by 
Congress  on  the  9th  of  August,  1777,  it  appears  that  Dr.  John  Mor- 
gan, late  Director-General  and  Chief  Physician  of  the  General  Hos- 
pital of  the  United  States,  had  been  removed  from  office  on  the 
9th  of  January,  1777,  by  reason  of  the  general  complaint  of  persons 
of  all  ranks  in  the  army,  and  the  critical  state  of  afifairs  at  that  time ; 
and  that  the  said  Dr.  John  Morgan,  requesting  inquiry  into  his  con- 
duct, it  was  thought  proper  that  a  Committee  of  Congress  should 
be  appointed  for  that  purpose. 

"  And  Whereas,  on  the  i8th  of  September  last,  such  a  committee 
was  appointed,  before  whom  the  said  Dr.  John  Morgan  hath,  in  the 
most  satisfactory  manner,  vindicated  his  conduct  in  every  respect  as 
Director-General  and  Physician-in-Chief,  upon  the  testimony  of  the 
Commander-in-Chief,  General  Officers,  officers  in  the  General  Hos- 
pital Department,  and  other  officers  in  the  army,  showing  that  the 
said  Director-General  did  conduct  himself  ably  and  faithfully  in  the 
discharge  of  the  duties  of  his  office ;    Therefore, 

"Resolved,  That  Congress  are  satisfied  with  the  conduct  of  Dr. 
John  Morgan,  while  acting  as  Director-General  and  Physician-in- 
Chief  in  the  General  Hospital  of  the  United  States,  and  that  this 

resojutjon  be  published." 

0 


THE   REVOLUTION.  127 

ingratitude,  rendered  somewhat  peevish,  perhaps,  by  trial 
and  disappointment,  as  his  "  Vindication"  shows,  but 
always  loyal  to  the  cause  and  to  his  chief.  His  is  one  of 
the  best  names  in  our  annals, — a  name  too  little  known 
to-day ;   almost  ignored  by  history. 

William  Shippen,  Jr.,  was  chief  physician  to  the  army 
for  four  years, — from  January,  1777,  to  January,  1781. 
Next  to  Morgan  and  Rush,  he  was  probably  the  most  dis- 
tinguished American  physician  of  his  generation.  He 
died  at  the  age  of  seventy-two,  in  1808,  within  the  mem- 
ory of  our  grandfathers,  and  for  more  than  forty-five 
years  was  constantly  before  the  eyes  of  Philadelphians. 
He  must  have  been  a  very  human  man :  able  and  diligent, 
with  much  of  what  we  call  magnetism  and  a  very  distinct 
individuality.  Devoutly  religious,  as  were  most  physi- 
cians of  that  time,  his  old  age  was  rendered  desolate  by 
the  death  of  an  only  son  whom  he  idolized. 

But  we  are  now  concerned  with  him  in  war  times.  He 
was  forty-one  years  old  when  Congress  raised  him  to  the 
highest  medical  office.  He  had  already  abandoned  his 
practice  for  army  service,  and  on  his  promotion  to  suc- 
ceed Morgan  he  entered  zealously  upon  his  duties.  We 
know  how  weary  and  difficult  was  the  task,  but  Shippen 
succeeded  where  his  predecessor  had  failed.  Various 
causes  contributed  to  this  success.  He  was  a  more  prac- 
tical person  in  many  ways ;  less  thin-skinned,  more  ready 
to  give  and  take,  more  facile  in  the  affairs  of  daily  life. 
Besides,  some  of  the  more  difficult  questions  had  already 
been  answered.  The  organization  was,  in  rough  shape, 
complete.  The  matter  of  ranking  was  settled,  that  of  sup- 
plies was  less  desperately  hopeless,  and  his  position  of 
authority  in  affairs  medical  was  absolutely  unquestioned 
throughout  the  country.  Indeed,  he  .seems  to  have  been 
less  grievously  harassed  and  pressed  for  time  than  Mor- 
gan had  been ;  for,  except  during  the  winter  of  i  Jj6  and 
1777,  he  managed  to  continue  his  anatomical  lectures  in 


128  MEDICINE    IN   AMERICA. 

Philadelphia  through  the  war.  Although  midwifery  was 
his  favorite  subject  and  that  for  which  he  was  most 
famous,  he  necessarily  abandoned  all  such  work  and  teach- 
ing, giving  himself  to  matters  concerned  with  the  saving 
of  life  rather  than  to  the  advent  of  the  coming  generation. 

The  great  step  in  advance  which  accompanied  Ship- 
pen's  promotion  was  the  wise  provision  by  the  Congress 
for  a  proper  geographical  division  of  the  army  into  de- 
partments and  a  selection  of  competent  medical  officers  for 
their  direction. 

For  the  Northern  Department,  Jonathan  Potts  was 
made  deputy  director-general,  with  John  Bartlett  physi- 
cian and  surgeon-general,  Malachi  Treat  physician- 
general,  and  Samuel  Forgue  surgeon-general.  In  the 
Eastern  Department  (east  of  the  Hudson  River),  Isaac 
Foster  was  deputy  director-general,  William  Burnett  phy- 
sician and  surgeon-general,  Ammi  Ruhamah  Cutter  phy- 
sician-general, and  Philip  Turner  surgeon-general.  In 
the  Middle  Department  (the  most  important),  John  Coch- 
ran was  physician  and  surgeon-general  (sennng  directly 
under  Shippen  himself),  Walter  Jones  physician-general, 
and  Benjamin  Rush  surgeon-general.  These  various 
offices,  which  sound  strangely  to  us,  with  our  simplified 
modern  system,  were  ably  filled,  mostly,  by  their  incum- 
bents, and  serious  friction  and  insubordination  soon  dis- 
appeared from  the  service.  Nearly  all  of  those  excellent 
officers  held  their  positions  throughout  the  war,  and,  their 
efficiency  increasing  with  experience,  the  various  depart- 
ments were  found  to  be  in  a  creditable  condition  on  the 
cessation  of  hostilities.  In  January,  1781,  some  months 
before  the  surrender  of  Cornwallis,  Shippen  retired  from 
the  service  and  was  succeeded  by  John  Cochran,  who  held 
his  new  position  until  the  peace.  A  Pennsylvanian,  like 
his  two  predecessors,  he  was  a  very  accomplished  and 
experienced  surgeon  and  the  personal  nominee  of  General 
Washington. 


THE    REVOLUTION.  129 

One  finds  little  to  record  of  the  personal  service  of  Ship- 
pen  during  his  term.  The  delegation  of  duties  to  their 
proper  officers  relieved  him  of  much  of  the  detail  that  had 
so  worn  upon  Morgan,  and  he  v^as  busied  in  receiving 
reports,  raising  and  forwarding  supplies,  establishing  hos- 
pitals, finding  accommodations  for  his  patients,  and  fight- 
ing epidemics. 

The  details  of  all  these  matters  are  admirably  recorded 
by  Packard,  who  has  well  drained  our  scanty  sources  of 
information.  The  contemporary  writings  of  the  period 
deal  but  little  with  such  questions.  Probably  the  best 
pictures  of  this  feature  of  the  Revolution  are  Thacher's 
entertaining  "  Military  Journal,"  the  Biography  of  John 
Warren,  James  Tilton's  "  Observations  on  Military  Hos- 
pitals," Toner's  "  Medical  Men  of  the  Revolution,"  an 
article  by  Mr.  Jordan  in  the  Pennsylvania  Magazine  of 
History  and  Biography  for  July,  1896,  and  "  British  and 
Colonial  Army  Surgeons,"  an  address  by  George  Lincoln 
Goodale,  1899. 

Of  the  various  matters  which  most  concerned  our  med- 
ical officers,  the  hospital  accommodations,  the  hospital 
mortality,  and  smallpox  call  for  a  brief  notice. 

We  have  seen  how  hospitals  were  established  at  Cam- 
bridge in  the  first  month  of  the  war,  and  we  know  that 
hospitals,  such  as  they  were,  continued  to  find  place  in 
various  locations :  temporarily  at  the  shifting  front,  more 
permanently  in  towns  conveniently  distant  from  active 
operations. 

One  of  the  most  interesting  of  those  large  permanent 
hospitals  was  at  Albany,  described  by  Thacher  after  the 
surrender  of  Burgoyne  at  Saratoga  in  1777.^  It  was  in 
the  department  of  Jonathan  Potts,  and  was  crowded  with 
Americans  and  with  British  and  Hessian  wounded  whose 
own  surgeons  acted  for  them.     Thacher  says,  "  I  have 


Military  Journal,  p.  134. 
9 


I30  MEDICINE    IN   AMERICA. 

been  present  at  some  of  their  capital  operations  and  re- 
marked that  the  EngHsh  surgeons  perform  with  skill  and 
dexterit}^,  but  the  Germans,  with  a  few  exceptions,  do  no 
credit  to  their  profession :  some  of  them  are  the  most 
uncouth  and  clumsy  operators  I  ever  witnessed,  and  ap- 
pear to  be  destitute  of  all  sympathy  and  tenderness  to- 
wards the  suffering  patient.  Not  less  than  one  thousand 
wounded  and  sick  are  now  in  this  city.  .  .  .  We  have 
about  thirty  surgeons  and  mates;  and  all  are  constantly 
employed.  .  .  .  Amputating  limbs,  trepanning  fractured 
skulls,  and  dressing  the  most  formidable  wounds,  have 
familiarized  my  mind  to  scenes  of  woe.  A  military  hos- 
pital is  peculiarly  calculated  to  afford  examples  for  profit- 
able contemplation  and  to  interest  our  sympathy  and 
commiseration." 

So  the  good  fellow  goes  on  for  two  pages.  He  was 
then  young,  of  small  experience,  and  entirely  unfamiliar 
with  the  scenes  of  a  similar  character  which,  even  in  civil 
practice,  the  accident  service  of  our  great  modern  hos- 
pitals affords  to  every  student  of  medicine. 

Another  very  interesting  description  of  a  large  mili- 
tary hospital  offering  a  variety  of  practice  is  given  by 
James  Tilton,  who  was  in  charge  of  the  American 
wounded  at  Williamsburg  after  the  surrender  of  Cornwal- 
lis.  The  French  troops  remained  in  the  place  and  their 
surgeons  attended  them.  His  account  of  French  methods 
is  in  part  very  pleasant,  in  marked  contrast  with  the  hor- 
rible conditions  which  existed  in  the  contemporary  hos- 
pitals in  Paris. 

"  Their  patients  appear  very  neat  and  clean,  above  all 
examples  I  had  ever  seen.  Each  patient  was  accommo- 
dated with  everything  necessary,  even  to  a  night  cap. 
Nevertheless  they  were  not  more  successful  than  we  were. 
Even  their  wounded,  with  all  the  boasted  dexterity  of 
the  French  to  aid  them,  were  no  more  fortunate  than  ours. 
I  was  led  to  attribute  their  failure  principally  to  two 


THE    REVOLUTION.  131 

causes.  For  ease  and  convenience  they  had  contrived  a 
common  necessary  for  their  whole  hospital,  the  college,  a 
large  building,  three  stories  high,  by  erecting  a  half  hexa- 
gon, of  common  boards,  reaching  from  the  roof,  down 
to  a  pit  in  the  earth.  From  this  perpendicular  conduil, 
doors  opened  upon  each  floor  of  the  hospital;  and  all 
manner  of  filth  and  excrementatious  matters  v/ere  dropped 
and  thrown  down  this  common  sewer  into  the  pit  below. 
This  sink  of  nastiness  perfumed  the  whole  house  very 
sensibly,  and  without  doubt,  vitiated  all  the  air  within 
the  wards." 

The  second  reason  assigned  for  their  failures  was  that 
they  prescribed  no  bark  or  other  tonics  and  stimulants. 

There  were  many  other  hospitals  established  at  various 
points  and  at  various  periods  of  the  war.  In  1776  there 
were  those  at  Peekskill  and  Fishkill  on  the  Hudson, 
crowded  with  wounded  soldiers  and  zealously  served  by 
the  young  surgeons.  In  Connecticut  there  was  a  large 
hospital  at  Stamford ;  later  there  was  one  in  Boston ;  but 
the  most  frequented  and  notable  institutions  were  those 
near  the  seat  of  war  in  New  Jersey  and  Pennsylvania, — 
at  Amboy,  Philadelphia,  Elizabethtown,  Fort  Lee,  New 
Brunswick,  Trenton,  Newark,  Princeton,  Bethlehem, 
Lititz,  and  Lancaster.  Perhaps  the  most  notorious  of  these 
was  the  one  at  Bethlehem,  which  was  established  in  De- 
cember, I  yy6.  It  was  organized  by  Shippen  and  Warren, 
who  saw  an  enormous  service  in  its  wards. 

The  severe  campaign  and  the  constant  fighting  of  that 
autumn  and  winter  had  grievously  depleted  the  American 
ranks,  and  from  many  quarters  the  disabled  were  gath- 
ered and  crowded  in  upon  this  haven.  Their  condition 
after  the  long  winter  journey  was  most  wretched;  the 
means  of  transportation  were  primitive,  the  roads  shock- 
ing, and  the  stores  almost  nil.  During  the  last  three 
weeks  of  the  year  sixty-two  men  died  in  the  hospital  from 
the  effects  of  exposure  in  transit,  not  from  recent  wounds ; 


132 


MEDICINE    IN    AMERICA. 


and,  to  add  to  the  horrors,  smallpox  broke  out  during  the 
early  months.  As  a  result  of  this  the  hospital  was  broken 
up  and  the  patients  transferred  to  Philadelphia  in  the 
spring.  Then  came  the  summer  campaign  of  1777  and 
the  evacuation  of  Philadelphia  by  the  Americans.  Our 
veteran  troops  remained  in  that  vicinity,  as  we  know, 
keeping  the  British  constantly  on  the  alert,  and  their  oper- 
ations necessitated  the  re-establishment  of  the  Bethlehem 
Hospital.  Lafayette,  wounded  at  BrandyAvine,  was  a  dis- 
tinguished patient  there  at  this  time.  Towards  the  end' of 
the  year,  in  spite  of  the  exertions  of  Rush,  who  had  been 
assigned  to  this  post,  the  hospital,  which  consisted  of  halls, 
churches,  and  hastily  constructed  sheds,  became  fright- 
fully overcrowded  and  filthy  beyond  modern  conception. 
Many  patients  had  to  remain,  after  their  discharge,  for 
lack  of  clothes  to  march  in,  and  fevers  carried  off  nearly 
five  hundred  men  in  the  course  of  a  few  weeks.^ 

The  tale  of  horror  drags  along,  but  even  in  modern 
days  it  has  a  strangely  familiar  sound.  It  came  to  an 
end  with  the  winter,  and  in  the  spring  of  1778  the  men 
moved  on. 

That  is  a  fair  sample  of  the  way  our  crippled  ancestors 
fared.  There  were  other  hospitals  and  other  men,  but  the 
tale  is  not  a  pleasant  one  and  its  sameness  bore  no  fruit. 

In  addition  to  wounds  and  septic  fevers,  smallpox  was 
constantly  present  in  some  portion  or  other  of  the  Ameri- 
can armies,  but  the  fierceness  of  this  scourge  had  been 


"  Packard  quotes  one  of  the  surgeons,  William  Smith,  who  states 
"  That  he  had  known  from  four  to  five  patients  die  on  the  same 
straw  before  it  was  changed,  and  that  many  of  them  had  been  ad- 
mitted only  for  slight  disorders.  Of  the  eleven  junior  surgeons  and 
mates,  ten  took  the  infection,  most  of  them  dangerously  so,  and 
one,  Dr.  Joseph  Harrison,  had  died,  and  of  the  three  hospital  stew- 
ards, two  died  and  the  third  narrowly  escaped.  Owing  to  the 
crowded  wards,  and  the  want  of  almost  every  necessary,  it  was  im- 
possible to  prevent  an  infection,  and  that  the  sufferings  of  the  sick 
could  not  be  attributed  to  negligence  or  inattention  of  the  surgeons 
and  physicians." 


THE    REVOLUTION.  133 

greatly  mitigated  by  the  introduction  of  inoculation,  and 
that  operation  had  become  well  established  throughout 
the  country.  Private  hospitals  for  the  practice  had  been 
placed  near  all  the  larger  cities  and  great  numbers  of 
persons  had  benefited  by  it;  still,  it  was  not  so  universal 
as  vaccination  has  since  become,  and  when  a  regiment  or 
army  corps  was  attacked  by  smallpox  the  death-rate  ran 
high. 

Fortunately,  from  Washington  down,  all  intelligent 
men  had  come  to  appreciate  the  value  of  inoculation,  and 
the  difficulty  of  free  intercommunication  prevented  irre- 
sponsible and  hysterical  persons  from  making  impossible 
the  application  of  that  remedy  to  the  exposed  troops. 

The  disease  resulting  from  inoculation  was  by  no  means 
so  troublesome  and  distressing  as  we  are  wont  to  think  it. 
Thacher  tells  us  of  an  early  epidemic  of  smallpox  in  the 
camp  at  Cambridge  before  Bunker  Hill.  At  that  time 
Church  had  issued  no  general  inoculation  orders,  but 
Thacher  thought  it  wise  to  undergo  the  operation,  as  he 
was  constantly  in  the  hospital,  and  says,  "  I  was  accord- 
ingly inoculated  by  my  friend  Dr.  John  Homans,  and 
have  passed  through  the  disease  in  the  most  favorable 
manner,  not  suffering  one  day's  confinement." 

The  next  year  (1776)  Washington  became  so  alarmed 
at  the  prospect  of  a  visitation  of  smallpox  that  he  estab- 
lished inoculation  hospitals  at  Morristown  and  had  the 
whole  army  of  the  Jerseys  inoculated.  This  far-seeing 
and  energetic  action  proved  of  infinite  benefit  to  the  troops, 
in  morale  as  well  as  in  health.  The  death-rate  from  inocu- 
lation, as  then  practised  under  such  teachers  as  Morgan 
and  Rush,  was  practically  nil,  the  confidence  of  the  troops 
was  confirmed,  and  the  numbers  and  efficiency  of  those  on 
duty  were  reasonably  assured  so  far  as  any  danger  from 
smallpox  was  concerned.  Indeed,  during  the  later  years  of 
the  war  those  epidemics,  which  had  been  so  dreaded  at  first, 
no  longer  prevailed  so  as  seriously  to  be  reckoned  with. 


134  MEDICINE    IN   AMERICA. 

Enough  has  been  said  to  illustrate  the  medical  men  of 
the  Revolution  and  the  sort  of  experiences  through  which 
they  passed.  In  the  department  of  medicine,  as  in  others, 
a  gradual  improvement  took  place  as  the  war  advanced, 
especially  after  the  French  alliance.  The  troops  and  the 
staff  together  grew  old  in  the  service,  and  with  experience 
came  a  simplified  routine  and  more  facile  and  hardy 
patients. 

The  Commander-in-Chief  also  had  always  an  earnest, 
kindly  care  for  the  comfort  of  his  troops ;  his  steady  over- 
sight in  this  department,  as  in  the  others,  brought  him 
into  close  touch  with  all  ranks  of  the  service;  and  his 
early,  always-increasing  popularity  is  pleasantly  witnessed 
by  our  voluminous  Thacher.  That  faithful  surgeon  was 
stationed  at  Peekskill  the  year  after  Saratoga,  and  with 
his  eulogy  of  his  general  let  us  close  this  brief  sketch  of 
Revolutionar}''  medicine : 

"  His  Excellency,  the  Commander-in-Chief,  made  a 
visit  to  our  hospital ;  his  arrival  was  scarcely  announced, 
before  he  presented  himself  at  our  doors. 

"  Dr.  Williams  and  myself  had  the  honor  to  wait  on 
this  great  and  truly  good  man.  through  the  different 
wards,  and  to  reply  to  his  inquiries  relative  to  the  con- 
dition of  our  patients.  He  appeared  to  take  a  deep  in- 
terest in  the  situation  of  the  sick  and  wounded  soldiers, 
and  inquired  particularly  as  to  their  treatment  and  com- 
fortable accommodations.  Not  being  apprised  of  his  in- 
tended visit  in  time  to  make  preparations  for  his  reception, 
we  were  not  entirely  free  from  embarrassment,  but  we 
had  the  inexpressible  satisfaction  of  receiving  his  Ex- 
cellency's approbation  of  our  conduct,  as  respects  the 
duties  of  our  department. 

"  The  personal  appearance  of  our  Commander-in-Chief 
is  that  of  a  perfect  gentleman  and  accomplished  warrior. 

"  He  is  remarkably  tall,  full  six  feet,  erect  and  well 
proportioned. 


THE    REVOLUTION.  135 

"  The  strength  and  proportions  of  his  joints  and 
muscles  appear  to  be  commensurate  with  the  pre-eminent 
powers  of  his  mind.  The  serenity  of  his  countenance, 
and  majestic  gracefulness  of  his  deportment,  impart  a 
strong  impression  of  that  dignity  and  grandeur  which 
are  his  peculiar  characteristics,  and  no  one  can  stand  in 
his  presence  without  feeling  the  ascendency  of  his  mind, 
and  associating  with  his  countenance  the  idea  of  wisdom, 
philanthropy,  magnanimity,  and  patriotism. 

"  There  is  a  fine  symmetry  in  the  features  of  his  face, 
indicative  of  a  benign  and  dignified  spirit.  His  nose  is 
straight,  his  eyes  inclined  to  blue.  He  wears  his  hair  in 
a  becoming  cue,  and  from  his  forehead  it  is  turned  back 
and  powdered  in  a  manner  which  adds  to  the  military  air 
of  his  appearance.  He  displays  a  native  gravity,  but 
devoid  of  all  appearance  of  ostentation.  His  uniform 
dress  is  a  blue  coat,  with  two  brilliant  epaulettes,  buff 
colored  under-clothes,  and  a  three  cornered  hat,  with 
black  cockade.  He  is  constantly  equipped  w4th  an  ele- 
gant small  sword,  boots  and  spurs,  in  readiness  to  mount 
his  noble  charger. 

"  There  is  not  in  the  present  age,  perhaps,  another  man 
so  eminently  qualified  to  discharge  the  arduous  duties  of 
the  exalted  station  he  is  called  to  sustain,  amidst  diffi- 
culties which  to  others  would  appear  insurmountable,  nor 
could  any  man  have  more  at  command  the  veneration  and 
regard  of  the  officers  and  soldiers  of  our  army,  even 
after  defeat  and  misfortune. 

"  This  is  the  illustrious  chief,  whom  a  kind  Providence 
has  decreed  as  the  instrument  to  conduct  our  country  to 
peace  and  independence." 


CHAPTER    VI. 

THE    EIGHTEENTH    CENTURY.        BENJAMIN    RUSH. 

Like  the  rest  of  our  national  history,  the  tale  of  Ameri- 
can medicine  really  begins  with  the  ending  of  the  Revolu- 
tion. Before  that  there  lived  and  worked  here  some  very 
eminent  men,  and  in  medicine,  as  in  other  departments  of 
American  life,  broad  and  deep  foundations  were  laid ;  but 
they  were  foundations  only,  and  not  until  the  end  of  the 
eighteenth  century  did  the  true  edifice  begin  to  be  reared. 
What  goes  before  is  largely  prefatory.  The  colonies  were 
provincial  in  science,  dependent  on  Europe  for  almost  all 
they  knew,  even  for  many  of  their  strongest  men;  but 
with  the  rising  of  the  nation  our  medicine  rose,  too ;  and 
although  our  young  men  continued  to  broaden  themselves 
by  study  and  travel  in  Europe,  we  came  very  early  to  de- 
velop a  fine  type  of  doctor,  and  American  practice  came 
to  be  well  known  and  effective  more  than  a  hundred  years 
ago. 

The  reasons  for  this  are  not  far  to  seek.  Unlike  our 
literature,  which  long  remained  immature,  largely  because 
of  its  scanty  cultivation,  medicine  was  from  the  very  first 
a  favorite  profession.  In  colonial  days  theology  and  law 
led  it,  but  with  political  emancipation  came  religious 
emancipation,  and  that  class  in  the  community  which  had 
furnished  recruits  to  the  ranks  of  the  clergy  came,  in  a 
very  few  years,  to  drift  largely  towards  medicine,  its  sister 
profession.  And  that  class  was  the  strongest  and  finest 
that  our  race  has  ever  produced.  Virile,  enterprising, 
clean-blooded,  near  the  soil,  yet  softened  by  cultivation, 
simple  but  shrewd,  country  born  mostly,  but  with  tradi- 
tions of  education  and  honest  breeding,  those  ancestors 
136 


BENJAMIN    RUSH.  137 

of  ours  took  up  life's  work  with  a  rush,  a  zest,  a  confi- 
dence, and  a  dogged  resolution  to  succeed  that  brought 
the  best  of  them  to  a  standing  and  importance  in  the 
community  such  as  our  European  confreres  have  not  yet 
attained. 

So  the  profession  of  medicine  became  a  popular  profes- 
sion. In  it  was  represented  every  family  of  importance 
throughout  the  land;  indeed,  in  some  families  it  became 
hereditary;  and  it  would  be  interesting  to  trace  the  ser- 
vices which  successive  generations  of  the  same  name  have 
rendered  our  art.  There  was  no  struggle  with  social 
prejudice  such  as  was  known  in  England :  the  abolition 
of  titles  and  primogeniture  ended  all  that.  There  were 
opportunity  and  a  welcome  for  men  of  all  ranks ;  the  de- 
mocracy of  science  became  a  very  real  thing.  The  hamlet 
knew*  no  more  important  man  than  the  village  doctor; 
the  nation  knew  few  more  eminent  figures  than  Benjamin 
Rush. 

In  those  early  days  our  men  of  science  were  more  men 
of  affairs  and  were  more  intimately  concerned  with  the 
wider  interests  of  the  people  than  they  have  since  become. 
Life  was  more  simple;  even  city  communities  were  small ; 
specialism  was  almost  unknown.  It  was  possible  for  an 
active  teacher  and  practitioner  to  be  distinguished  also  in 
literature  and  politics.  It  was  possible  even  for  country 
doctors  to  have  some  side  occupation,  and  Rush  advised 
such  men  to  cultivate  a  farm.  The  ablest  of  the  faculty 
pursued  many  branches  of  science ;  and  so  late  as  the  mid- 
dle of  the  last  century  we  find  a  Bigelow  practising  medi- 
cine, teaching  therapeutics,  lecturing  on  technology,  and 
writing  rhymes  in  Greek. 

So  it  was  a  very  broad  and  humanizing  life.  The 
technical  attainments  of  those  men  were  not  of  the  very 
highest,  perhaps;  but  they  knew  life,  they  were  securely 
placed  among  their  own  people,  they  were  possessed  of 
shrewd  common  sense  and  mother  wit,  they  were  very 


138  MEDICINE    IN   AMERICA. 

real  products  of  their  time  and  place,  and  they  developed 
a  facility  in  practice  and  a  popular  success  such  as  the 
world  has  rarely  seen. 

Almost  coincident  with  the  Revolution,  which  was  so 
great  an  impulse  in  itself,  there  was  the  establishment  of 
medical  schools  and  hospitals,  either  immediately  pre- 
ceding or  immediately  following  the  war :  the  school  and 
hospital  in  Philadelphia,  the  most  important  of  all  for  a 
time ;  the  school,  especially,  being  the  Mecca  of  American 
medicine  for  a  great  many  years;  and  of  all  those  who 
made  that  school  great,  no  man  more  than  Benjamin 
Rush  stamped  himself  upon  it  and  upon  the  teaching  and 
practice  of  the  whole  country.  Indeed,  if  one  were  obliged 
to  name  the  one  greatest  figure  in  our  medical  annals, 
perhaps  Rush  would  be  the  man.  A  recent  English 
writer^  has  some  pleasant  words  to  say  about  his  posi- 
tion and  fame.  He  was  called  the  American  Sydenham 
by  Isaac  Lettsom,  who  said  that  he  approached,  if  not 
exceeded,  Sydenham  in  grandeur  and  compass  of  thought. 
American  contemporary  waiters  called  him  the  Hippoc- 
rates of  Pennsylvania,  and  Hack  Tuke  dubbed  him  the 
American  Fothergill.  Now,  all  these  are  very  pleasant 
epithets  and  leave  one  to  suppose  that  his  genius  was 
nearly  universal.  Although  he  shared  the  attributes  of 
various  great  physicians,  he  was  almost  equally  distin- 
guished, both  for  good  and  ill,  in  fields  other  than  medi- 
cal, and  some  study  of  his  life  and  character,  which 
developed  and  flourished  in  the  Revolutionary  and  subse- 
quent years,  is  worth  the  attention  of  every  thoughtful 
American. 

Rush  had  warm  friends  and  bitter  enemies.  He  was 
an  ardent  and  conspicuous  patriot,  yet  at  one  time  un- 
friendly to  Washington;  he  was  an  accomplished  physi- 
cian, yet  hated  by  many  of  the  best  of  his  colleagues;   he 


Disciples  of  ^sculapius,  by  Sir  Benjamin  Ward  Richardson,  M.D. 


BENJAMIN    RUSH.  139 

was  a  faithful  student  of  science,  yet  he  tied  himself  to  a 
system ;  he  was  an  unselfish  philanthropist,  yet  good  men 
accused  him  of  bringing  ruin  on  his  community;  he  was 
a  great  teacher,  yet  his  disciples  put  him  to  shame  by  their 
extravagances ;  he  sued  his  traducer  for  libel,  but  he  gave 
the  money  to  the  poor. 

He  was  a  very  human,  very  strenuous,  many-sided 
man;  optimistic  for  his  country,  but  pessimistic  towards 
the  end ;  democratic  at  the  first,  but  sceptical  at  the  last ; 
yet  through  it  all,  and  constant,  a  faithful  devotee  of 
science  and  an  unswerving  believer  in  the  revealed  religion 
of  his  day. 

Benjamin  Rush  was  born  on  December  24,  1745,  old 
style,  and  died  on  April  19,  181 3, — a  very  momentous 
era.  Of  such  a  man  it  is  interesting  to  note  the  personal 
appearance  and  characteristics. 

One  who  remembered  him  writes  of  him  as  he  was  in 
the  last  five  years  of  his  life,^ — 

"  He  was  above  the  middle  height,  very  erect,  rather 
slender,  with  small  bones,  and  rather  thin ;  his  hands  and 
wrists,  feet  and  ankles  being  small  and  finely  formed. 
His  face  was  thin,  nose  aquiline;  eyes  beautifully  set, 
large,  blue,  mild,  and  benevolent;  forehead  broad  and 
high;  head  long  in  the  transverse  diameter  and  nearly 
bald  from  the  crown  forward ;  his  hair  clubbed  behind 
and  powdered.  His  face  was  of  a  fair  and  healthy  com- 
plexion, not  handsome  or  what  is  called  fine  looking,  for 
his  cheeks  were  fallen  in,  many  of  his  front  teeth  lost, 
and  age,  with  care,  had  left  its  wrinkles.  His  countenance 
in  conversation  was  highly  animated.  His  infrequent 
smile  was  highly  gracious,  but  he  hardly  ever  laughed. 
.  .  .  When  walking  the  street  he  uncovered  to  every 
one,  poor  or  rich,  who  uncovered  to  him.  His  dress  was 
very  plain,  generally  of  drab-colored  cloth;    he  rode  in 


Benjamin  Rush,  by  Samuel  Jackson,  Philadelphia,  i860. 


I40  MEDICINE    IN   AMERICA. 

a  plain  vehicle  with  two  wheels  and  one  horse,  the  same 
little  negro  by  his  side,  who  had  lived  with  him  more 
than  thirty  years — master  and  man  now  grown  old  to- 
gether, 

"  His  bearing  was  very  simple  and  artless,  without  a 
semblance  of  affectation,  remarkable  for  kindness,  cordi- 
ality and  even  condescension.  ...  In  conversation  he  was 
acknowledged  by  all  to  be  pre-eminent,  yet  he  did  not  ap- 
pear to  be  at  all  self-complacent  of  his  colloquial  powers. 
He  never  interrupted  another  as  the  fashion  now  runs. 
...  In  fine  he  was  the  accomplished  Christian  gentle- 
man, whose  imposing  first  appearance  subdued  every  mind 
and  won  every  heart.  .  .  .  His  portrait,  painted  by  the 
eminent  Sully,  is  a  perfect  likeness." 

All  this  is  a  very  pleasant  picture.  To  be  sure,  it  is 
drawn  by  an  old  man,  jealously  reminiscent  of  his  youth 
and  his  early  heroes,  but  others  tell  a  similar  story  and 
make  us  see  a  striking  type  of  man. 

Rush  was  not  of  the  Philadelphia  gentry  class,  but  of 
the  best  type  of  yeomen.  For  four  generations  his  pater- 
nal ancestors  had  been  Americans,  the  immigrant  John 
Rush,  one  of  Cromwell's  old  captains,  having  come  out 
to  Penn's  colony  in  1683  and  settled  in  Byberry  Town- 
ship, thirteen  miles  northeast  of  Philadelphia.  There  he 
and  his  thrifty  descendants  lived  and  died  as  farmers; 
and  there,  on  Poquestion  Creek,  in  1745,  Benjamin  Rush 
was  born.  It  was  the  year  of  Louisburg  and  Prestonpans 
and  Fontenoy;  George  II.  was  king  and  George  Wash- 
ington was  still  a  boy. 

It  is  interesting  to  know  something  of  the  boyhood  of 
distinguished  men,  but  of  Rush's  we  know  very  little.  He 
left  the  ancestral  home  when  he  was  a  chikl  of  six  and  saw 
it  again  only  after  sixty-two  years.  He  had  gone  then 
into  the  neighborhood  by  chance,  on  business,  and  wrote 
a  letter  about  it  to  his  old  friend,  John  Adams.  It  is  a 
charming,  characteristic  letter,  and  describes  scenes  and 


BENJAMIN    RUSH.  141 

emotions   through    which    most   of   us    Americans    have 
passed.^ 

"  I  was  called  lately  to  visit  a  patient  in  that  neighbor- 
hood, and  having  with  me  my  youngest  son,  I  thought  I 
would  avail  myself  of  the  occasion  to  visit  the  farm  on 
which  I  was  born,  and  where  my  ancestors  for  several 
generations  had  lived  and  died.  In  approaching  it,  I  was 
agitated  in  a  manner  I  did  not  expect.  The  access  was 
altered,  but  everything  around  was  nearly  the  same  as 
in  the  days  of  my  boyhood,  at  which  time  I  left  it.  The 
family  received  me  kindly,  and  discovered  a  disposition 
to  satisfy  my  curiosity  and  gratify  my  feelings.  I  asked 
permission  to  conduct  my  son  upstairs,  to  see  the  room 
in  which  I  drew  my  first  breath  and  made  my  first  unwel- 
come noise  in  the  world,  and  where  first  began  the  affec- 
tionate cares  of  my  beloved  and  excellent  mother.  I  next 
asked  for  a  large  cedar  tree  which  once  stood  before  the 
door,  planted  by  my  father's  hand.  It  had  been  con- 
verted into  the  pillars  of  the  piazza.  Filled  with  emo- 
tion, I  embraced  the  one  nearest  me.  I  next  inquired  for 
the  orchard  planted  by  the  same  hand,  and  was  conducted 
to  an  eminence  behind  the  house,  where  I  saw  a  number  of 
apple  trees  which  still  bore  fruit,  tO'  each  of  which  I  felt 
something  like  the  affection  of  a  brother.  The  building, 
which  is  of  stone,  bears  marks  of  age  and  decay.  On  one 
of  the  stones,  I  discovered  the  letters  J.  R.  Before  the 
house  flows  a  small  but  deep  creek,  abounding  in  pan- 
fish.  The  farm  consists  of  ninety  acres,  in  a  highly  culti- 
vated state.  The  owner  did  not  want  to  sell,  but  I  begged 
if  he  ever  should  incline  to  dispose  of  it,  to  make  me,  or 
one  of  my  surviving  sons  the  first  offer.  While  I  sat  in 
its  common  room,  I  looked  at  its  walls,  and  thought  how 
often  they  had  been  made  vocal  by  my  ancestors, — to 
conversations  about  wolves,  bears,  and  snakes,  in  the  first 


'  Watson's  Annals  of  Philadelphia. 


142  MEDICINE    IN   AMERICA. 

settlement;  afterwards,  about  cows  and  calves  colts  and 
lambs;  and  at  all  times  with  prayers,  and  praises,  and 
chapters  read  audibly  from  the  Bible,  for  all  who  had 
inhabited  it  of  my  family,  were  pious  people,  chiefly  of 
the  sect  of  Quakers  and  Baptists.  On  my  way  home,  I 
stopped  to  view  a  family  graveyard,  in  which  were  buried 
three,  and  a  part  of  four  successive  generations,  all  of 
whom  were  the  descendants  of  Captain  John  Rush,  who, 
with  six  sons  and  three  daughters,  followed  William 
Penn  to  Pennsylvania,  in  1683.  He  had  been  a  captain 
of  a  troop  of  horse  under  Oliver  Cromwell.  ...  I  retain 
as  his  relics,  his  sword,  watch,  and  Bible-leaf,  on  which 
are  inscribed  in  his  own  hand,  his  marriage,  and  chil- 
dren's births  and  names.  My  grandfather,  James  Rush, 
has  his  gravestone  and  inscription  in  the  aforesaid  grave- 
yard. .  .  .  While  considering  this  repository  of  the  dead, 
then  holding  my  kindred  dust,  my  thoughts  ran  wild,  and 
my  ancestors  seemed  to  stand  before  me  in  their  homespun 
dresses,  and  to  say,  '  What  means  this  gentleman  by  thus 
intruding  upon  our  repose?'  and  I  seemed  to  say,  '  Dear 
and  venerable  friends,  be  not  disturbed.  I  am  one  who  in- 
herits your  blood  and  name,  and  have  come  here  to  do 
homage  to  your  Christian  and  moral  virtues ;  and  truly  I 
have  acquired  nothing  from  the  world,  though  raised  in 
fame,  which  I  so  highly  prize  as  the  religious  principles  I 
inherited  from  you ;  and  I  possess  nothing  that  I  value 
so  much  as  the  innocence  and  purity  of  your  character.'  " 
Rush,  with  his  mother,  brothers,  and  sisters,  left  the 
old  place  when  his  father  died.  He  was  but  six  years  old. 
The  family  moved  into  Philadelphia,  where  Mrs.  Rush 
opened  a  shop.  She  seems  to  have  been  an  excellent,  in- 
telligent woman,  for  she  did  well  by  her  children,  most  of 
whom  made  some  success  of  life.  At  any  rate,  she  had 
some  rather  superior  connections,  among  them  the  Rev. 
Doctor  Finley,  who  afterwards  became  President  of 
Princeton  College. 


BENJAMIN    RUSH.  143 

This  accomplished  gentleman  was  keeping  a  successful 
country  academy  when  Rush  was  a  boy,  and  three  years 
after  the  death  of  his  father  the  lad  was  taken  by  this  uncle 
for  his  education.  The  academy  was  at  Nottingham,  in 
Southern  Maryland,  on  the  Patuxent,  not  far  from  the 
famous  town  of  Brandywine,  and  about  twenty-two  miles 
southeast  of  modern  Washington.  It  was  a  remote  place 
in  those  days,  inhabited  by  a  simple  people,  and  the  fact 
that  the  academy  became  famous  and  developed  a  college 
president  speaks  volumes  for  the  excellent  Dr.  Finley. 
Ramsay  has  some  kindly  words  to  say  for  Nottingham  and 
the  inhabitants  thereof.  To  their  influence  and  the  life 
there  among  such  primitive,  hard-working,  God-fearing 
folk  he  ascribes  much  of  the  good  morals  and  good  man- 
ners of  young  Rush, — all  of  which  is  doubtless  very  pretty 
and  very  fanciful.  The  facts  seem  to  have  been  that  the 
boy  lived  for  five  years  in  the  country,  had  a  good  tutor, 
and  stuck  to  his  work.  Indeed,  in  gleaning  what  few 
facts  have  been  written  about  Rush  by  his  eulogists,  so 
much  is  found  about  his  piety  and  other  virtues  that  we 
should  be  inclined  to  set  him  down,  with  Weems's  Wash- 
ington, as  an  impossible  prig,  did  we  not  know  from  his 
life  and  works  that  he  was  much  as  other  men  are. 

Southern  Maryland  was  a  wild,  uncouth,  half-cleared, 
ill-cultivated  region  in  those  ancient  days,  inhabited  by 
such  an  assemblage  of  blacks,  poor  whites,  and  down-at- 
heel  sporting  squires  as  followed  the  fortunes  of  Harry 
Warrington;  and  the  famous  academy,  if  it  resembled 
at  all  the  institutions  of  its  time,  was  doubtless  a  very 
humble  affair.  But  gold  lace  and  silk  stockings  were  rare 
enough  anywhere  in  America  one  hundred  and  fifty  years 
ago.  The  farms,  the  backwoods,  and  the  struggling  sea- 
board towns  did  their  work  and  turned  out  men;  and, 
after  all,  it  is  with  men  that  we  are  now  concerned. 

Such  early  experiences — the  farm  life,  the  homely  sur- 
roundings, the  secluded  school,  and  the  kindly  pedagogue 


144  MEDICINE    IN    AMERICA. 

— did  leave  their  permanent  mark  upon  Rush.  It  was  a 
simple  nature,  with  an  old-fashioned,  straightforward 
outlook  and  a  credulity  which  sometimes  led  him  astray. 
He  acquired  a  religious  faith  which  stood  by  him,  un- 
troubled by  experiences  of  travel  and  a  wide  acquaintance 
with  men ;  and  a  naivete  which  precluded  a  keen  sense  of 
humor.  Many  of  us  can  remember  the  type  of  man — 
familiar  enough  to  our  youth — who  was  born  in  the  eigh- 
teenth century,  and  can  recall  the  curious  Old- World 
outlook  on  life,  —  an  outlook  which  took  it  all  more 
seriously  than  we  do  to-day.  The  wit  of  one  generation 
is  mostly  ashes  to  the  next ;  the  old  jokes  and  sayings  are 
fiat  and  unprofitable  to  us,  and  we,  in  our  turn,  doubtless, 
shall  bore  our  descendants. 

The  five  years  at  Nottingham  passed  without  special 
note;  without  the  change  and  the  long  vacations  of  our 
later  years.  The  boy  studied  hard,  and  acquired  a  ground- 
ing in  the  Greek  and  Latin  classics  which  stood  by  him 
through  life.  His  health  may  have  suffered  somewhat,  for 
throughout  his  career  he  was  not  robust,  and  was  said  to 
have  been  of  a  phthisical  tendency  from  his  youth.  At 
fourteen,  then,  he  left  school  and  was  sent — by  whom  or 
in  what  fashion  does  not  appear — to  Princeton  College, — 
a  young  institution  but  thirteen  years  established,  and  then 
under  the  presidency  of  Samuel  Davies.  The  curriculum 
was  a  very  elementary  one;  indeed,  Rush  had  already 
covered  most  of  the  prescribed  ground,  for  he  saw  but  a 
year  of  college  life,  and  was  graduated  a  Bachelor  of  Arts 
at  the  following  Commencement,  in  1760,  while  he  was 
still  in  his  fifteenth  year. 

We  are  wont  to  call  this  present  time  an  age  of  young 
men,  but  that  early  time  before  the  Revolution  was  even 
more  remarkable.  In  England  were  many  youths  of  pre- 
cocious political  sagacity,  such  as  the  two  Pitts,  Fox,  and 
others ;  in  this  country  Washington  was  a  leader  of  men 
at  nineteen ;  and  Hamilton,  at  thirty-two,  was  a  construe- 


BENJAiA'IIN    RUSH.  145 

tive  statesman  of  the  highest  rank,  a  proved  man  and 
Secretary  of  the  Treasury  of  the  United  States.  In  the 
same  way  our  Rush  began  his  life  work  at  an  age  when 
most  of  us  are  High  School  boys,  and  he  became  a  college 
professor  at  the  age  of  twenty-four,  as  we  shall  see. 

Up  to  the  time  of  his  leaving  college  Rush  had  planned 
no  career.  He  had  read  Hippocrates,  as  he  had  read 
Cicero,  and  had  loved  nature  no  more  than  he  had  loved 
the  rostrum  of  the  debating  club.  Indeed,  many  of  his 
friends  urged  him  to  study  for  the  bar,  and  predicted  for 
him  a  brilliant  future  as  a  lawyer,  basing  their  opinion  on 
his  youthful  prowess  as  an  "  orator." 

Happily  for  Rush,  while  his  mind  was  still  undecided, 
his  good  uncle.  Dr.  Finley,  intervened.  He  knew  better 
than  any  others  the  aptitude  and  abilities  of  his  old  pupil, 
and  it  was  by  his  strong  advice  that  medicine  became  the 
boy's  choice.  So  there  we  have  Rush  again,  at  the  age  of 
fifteen,  settled  at  hard  work  on  anatomy  and  chemistry, 
spreading  plasters  and  compounding  tinctures  in  the  sur- 
gery of  the  distinguished  Dr.  Redman,  of  Philadelphia. 

That  well-known  man — Redman — has  had  scant  notice 
in  these  pages  and  deserves  a  word,  at  least,  here ;  for  he 
was  widely  respected  in  his  day,  and  was  famous,  if  for 
nothing  else,  as  the  preceptor  of  many  men  subsequently 
.eminent,  Rush  among  them. 

John  Redman  was  a  Philadelphian  by  birth,  and  was 
thirty-eight  years  old  when  Rush  became  his  pupil.  He 
had  practised  in  Bermuda  and  had  studied  in  London  and 
Edinburgh.  He  was  an  able  practitioner,  popular  with  all 
classes,  was  one  of  the  earliest  physicians  to  the  Pennsyl- 
vania Hospital,  and  the  first  President  of  the  College  of 
Physicians.  Like  most  doctors  of  the  time,  he  believed  in 
systems,  and  had  attached  himself  to  the  teaching  of  Boer- 
haave ;  although,  we  are  told,  his  practice  was  formed  by 
the  rules  of  Sydenham ;  all  of  which  probably  means  that 
"  he  looked  upon  disease  as  a  condition  in  which  bodily 


146  MEDICINE    IN    AMERICA. 

action  or  natural  activities,  being  disturbed  or  unsettled, 
could  take  place  only  with  difficulty,"  *  and  that  he  trusted 
to  the  healing  power  of  nature  and  practised  a  simple 
therapeutics. 

With  Redman  his  more  famous  pupil  lived  and  studied 
for  six  years,  and  they  were  not  the  least  vital  years  in 
our  medical  history.  Shippen  and  Morgan  were  coming 
home,  the  medical  school  was  being  founded,  and  a  yellow 
fever  epidemic  was  making  itself  remembered.  Years 
afterwards  Rush  wrote  about  those  times  and  the  fever, — 
one  of  the  latest  of  his  manifold  works.^ 

He  was  always  a  good,  studious  lad,  and  in  his  new 
tasks  his  punctuality  was  faultless,  for  during  all  those 
six  years  he  was  absent  from  his  work  but  two  days.  In- 
deed, he  did  a  variety  of  commendable  things;  he  trans- 
lated Hippocrates  into  English — a  useful  self-appointed 
undertaking— and  he  kept  a  commonplace  book.  That 
latter  work  and  practice  he  followed  through  life.  He  de- 
veloped the  book  into  a  sort  of  system  of  double  entry; 
two  little  volumes  ran  side  by  side :  one  was  a  record  of 
facts,  the  other  a  series  of  reflections  and  comments.  That 
was  an  era  of  thoughtful  composition  and  careful  pen- 
manship, not  yet  demoralized  by  the  typewriter. 

Those  must  have  been  pleasant  and  easy-going  times  in 
old  Philadelphia,  if  we  may  take  Rush's  word.  The  win- 
ters were  long  and  hard,  which  conduced  to  much  heavy 
eating  and  tavern  drinking,  and  folk  seem  to  have  en- 
livened the  hours  with  four  or  five  meals  a  day.  There 
was  little  poverty;  they  all  lived  well.  The  long,  hot 
summers  made  agreeable  further  drinks  of  great  variety. 
"  Their  food  was  simple,  and  taken  chiefly  in  solid  form. 
The  liquors  used  with  it  were  punch,  London  porter,  and 


*Roswell  Park,  An  Epitome  of  the  History  of  Medicine. 
'  An  Inquiry  into  the  Comparative  States  of  Medicine  in  Phila- 
delphia between  the  Years  1760  and  1766  and  1805. 


BENJAMIN   RUSH.  147 

sound  old  Madeira  wine."  Most  of  that,  we  are  told,  was 
changed  later,  and  the  Philadelphia  of  1805  was  distin- 
guished for  its  frugality  and  sobriety. 

Be  all  of  which  as  it  may,  young  Rush  survived  the 
early  cheerful  days;  he  clung  to  his  task,  delighted  the 
heart  of  his  master,  learned  all  that  there  was  to  know, 
and,  at  the  age  of  twenty-one,  started  out  on  his  travels  in 
search  of  a  degree. 

It  was  in  the  year  1766  that  Rush  went  to  Europe. 
The  years  between  1763  and  1775  were  anxious  and 
troublous  ones  in  America;  but,  in  spite  of  that,  our  youth 
were  more  and  more  resorting  to  the  old  countries,  and 
Rush  found  compatriots  in  all  the  great  cities.  His  first 
objective  was  Edinburgh  and  its  famous  medical  school, 
then  at  the  height  of  its  reputation  under  the  celebrated 
Cullen.  With  him  the  American  became  a  great  favorite, 
and  Cullen  saw  there  an  opportunity  to  extend  his  in- 
fluence in  the  New  World.  Of  the  Edinburgh  life  and 
work  Rush  had  experience  for  two  years. 

He  must  have  been  a  man  of  great  promise  and  a  pride 
to  his  teachers ;  for,  besides  his  native  genius,  he  had  be- 
hind him  six  years  of  arduous  medical  work.  He  was 
graduated  M.D.  in  1768,  and  defended  the  thesis  De  Con- 
coctione  cibomm  in  ventriculo. 

His  various  eulogists  tell  of  a  little  side  issue  in  his 
Edinburgh  career.  It  seems  that  in  1766  the  presidency 
of  his  alma  mater,  Princeton  College,  became  vacant,  and 
the  trustees  elected  to  the  place  Dr.  Witherspoon,  of  Pais- 
ley, in  Scotland.  That  reverend  gentleman  declined  the 
honor  when  he  was  notified,  thinking  the  new  field  too 
hopelessly  insignificant  and  remote.  Thereupon  the  trus- 
tees wrote  Rush  to  call  upon  him  and  urge  his  acceptance. 
We  must  suppose  the  young  man.  very  eloquent  or  the 
old  one  very  unstable,  for  this  intercession  had  the  desired 
effect.  Possibly  Dr.  Witherspoon  took  the  alumnus  to 
be  a  fair  type  of  the  youths  with  whom  he  would  have  to 


148  ^lEDICINE    IN    AMERICA. 

deal.  At  any  rate,  to  America  he  went  forthwith,  to  the 
joy  of  his  new  constituents ;  he  presided  over  the  College 
with  discretion  and  zeal,  he  became  a  patriot  when  patriot- 
ism was  the  fashion,  and  he  came  to  sit  with  his  young 
friend  Rush  in  the  new  Continental  Congress,  where  they 
both  signed  the  famous  Declaration. 

Even  with  his  two  years  in  Edinburgh,  Rush  was  still 
unsatisfied.  That  same  summer  he  journeyed  to  London 
and  spent  several  months  going  about  the  great  hospitals 
there,  attending  lectures  and  doing  other  such  post-grad- 
uate work  as  came  to  hand. 

Franklin  was  then  in  London.  Through  his  introduc- 
tion Rush  met  most  of  the  well-known  men  of  the  day, 
and  by  his  persuasions  he  was  induced  to  go  to  Paris  with 
funds  provided  by  the  kindly  philosopher  himself,  his  own 
purse  having  run  dry.  There  he  polished  up  his  French 
and  saw  such  simple  wonders  as  that  gay  city  had  to  show 
to  poor  American  students. 

In  such  fashion  passed  the  first  year  after  graduation; 
but  at  last  his  impatience  could  endure  no  more,  and  he 
returned  to  Philadelphia  in  August,  1769. 

The  little  experience  in  Paris  and  the  long  voyage  home 
were  the  end  of  recreation  for  Rush.  For  the  remainder 
of  his  life  he  never  rested.  He  belonged  to  the  class  of 
men  who  do  things,  and  for  such  there  is  no  rest.  He 
hungered  for  work ;  the  more  he  did  the  more  he  saw  to 
do.  He  once  said  that  he  dreaded  death  only  because  it 
meant  the  end  of  practising  medicine.  He  had  that  kind 
of  genius  which  succeeds  because  it  is  unceasing,  method- 
ical, thorough  ;  never  dilatory,  never  agitated,  but  prompt, 
clear-headed,  final.  It  was  a  broad  but  not  a  deep  mind. 
A  multitude  of  tasks  was  done,  and  well  done ;  the  bear- 
ings and  perspectives  were  clear  and  the  reasoning  acute ; 
but  the  real  meaning  of  phenomena  was  sometimes  ob- 
scure even  to  Rush,  and  his  one  weakness  lay  in  assuming 
what  still  remained  to  be  proved. 


BENJAMIN   RUSH.  149 

Chemistry  had  been  his  special  pursuit  during  much  of 
his  time  in  Europe.  It  interested  him,  and  he  knew  from 
his  correspondents  at  home  that  in  that  branch  there  was 
an  opening  in  the  new  medical  school.  We  must  not  sup- 
pose that  all  this  time  he  had  remained  obscure  or  un- 
known. The  favorite  pupil  of  Redman  and  Cullen  had 
professional  friends  in  plenty :  Bond,  Kuhn,  Shippen,  and 
Morgan  had  marked  him  for  their  own.  He  returned  to 
Philadelphia  with  a  reputation  ready  made  in  that  town 
where  every  man  knew  every  other,  and  he  had  hardly 
landed  when  he  was  elected  to  the  chair  of  Chemistry  in 
the  College  of  Philadelphia. 

Rush  was  not  a  great  chemist,  though  careful  and  pains- 
taking; but  he  was  a  great  teacher.  He  had  that  inde- 
scribable something  which  makes  men  listen  and  think. 
He  had  things  to  say  which  were  worth  hearing,  and  he 
said  them  well.  It  was  not  the  ardor  of  the  prophet,  but 
the  enthusiasm  of  the  cultivated  articulate  pleader.  He 
took  infinite  pains,  he  was  never  slovenly;  his  work  was 
never  extempore,  but  was  carefully  prepared.  Lectures 
are  dreary  things  with  most  men, — poor  methods  of  im- 
parting exact  knowledge, — but  Rush  made  them  very  live 
indeed.  The  students  were  never  bored  because  their 
teacher  was  never  bored.  Every  year  he  revised  carefully 
what  he  had  to  say  and  said  it  with  new  force.  It  was 
all  so  well  done,  too.  The  manner  was  worthy  of  the 
matter.  His  voice  was  mellow,  far-reaching,  delightful. 
His  diction  was  perfect.  And  it  was  all  so  human.  Read 
those  published  talks  of  his  and  compare  them  with  the 
printed  words  of  others :  with  good  old  Peter  Middle- 
ton's,  if  one  may  be  so  unkind.  Rush  never  indulged  in 
pompous  phrasing,  in  abstract  generalities,  in  jingling  the 
spheres,  in  dreary  citations,  in  sonorous  commonplaces, 
in  melancholy  mouthings.  He  talked  about  very  real 
things,  and  men  and  women.  He  was  alert,  pithy,  pointed. 
He  discoursed  of  theories,  but  he  illustrated  with  facts. 


I50  MEDICINE    IN    AMERICA. 

He  quoted  the  classics,  but  he  urged  them  home.  He 
clung  to  the  earth,  but  he  pointed  forward.  The  best  of 
his  students  were  captivated ;   even  the  dull  could  follow. 

His  were  called  great  gifts,  but  they  were  not  gifts. 
He  was  born  with  that  subtile  thing  called  charm,  but  he 
grew  to  eloquence  with  practice,  with  patience,  with  hard, 
constant  work,  with  enthusiasm.  And  he  inspired  his 
hearers.  Perhaps  that  was  the  great  thing  he  did  in  the 
world.  His  preaching  and  his  practice  were  carried  to  the 
ends  of  the  land  by  his  thousands  of  pupils ;  but  they  car- 
ried with  them,  too,  new  ideals  of  work,  of  the  dignity  of 
their  profession,  of  the  privileges  of  their  calling,  of  the 
value  of  human  life,  of  the  meaning  of  science,  of  the  sig- 
nificance of  labor,  of  the  pride  in  achievement,  of  the  joy 
in  true  progress. 

Such  were  some  of  the  things  that  came  out  of  the  man, 
and  if  he  had  done  nothing  else  we  should  look  back  on 
him  as  the  first  great  American  teacher. 

We  hear  much  solemn  talk  nowadays  about  the  decline 
of  the  ethical  standard  in  medicine.  Careful  inquiry  fails 
to  substantiate  the  claim,  and  the  story  of  so  admirable  a 
man  as  Rush  leads  one  to  think  that  even  he  sometimes 
subordinated  science  to  business. 

After  being  established  in  the  professor's  chair  he  pro- 
ceeded to  seek  patients,  and  in  this  he  was  not  above 
methods  which  the  strict  among  us  to-day  would  call  ad- 
vertising. It  was  a  trick  of  the  times,  and  he  was  in  excel- 
lent company.  He  was  a  clever  man  and  wrote  for  the 
public;  he  was  an  agreeable  man  and  attracted  friends. 
As  a  youth  he  had  written  biographical  anecdotes  of  the 
Rev.  Gilbert  Tennent,  and  he  now  devoted  his  consider- 
able leisure  to  urging  the  abolition  of  slavery  in  America. 
Such  exertions  were  most  commendable  and  brought  him 
the  warm  friendship  of  Quakers  in  Philadelphia.  One 
cannot  call  biographical  notes  and  essays  on  popular  topics 
improper  methods  of  advertising — if  so,  many  skirts  are 


BENJAMIN   RUSH.  151 

unclean ;  but  he  took  to  leading  a  mild  sort  of  temperance 
crusade  and  gave  public  lectures  on  hygiene.  Doubtless 
none  but  a  purist  would  object  to  such  methods  of  draw- 
ing attention  to  his  own  accomplishments,  but  there  are 
many  such  purists  in  these  days.  However,  as  we  have 
said,  he  but  followed  the  fashion  of  his  time;  and  doubt- 
less some  of  our  modern  doctors  would  be  broader  and 
more  useful  men  if  they  would  exert  themselves  in  season 
to  preach  outside  of  the  prescribed  lines. 

One  of  Rush's  earliest  and  most  interesting  publica- 
tions was  an  address  delivered  before  the  Philosophical 
Society  in  1774:  "An  Inquiry  into  the  Natural  History 
of  Medicine  among  the  Indians  of  North  America,  with 
a  Comparative  View  of  their  Diseases  and  Remedies  with 
those  of  Civilized  Nations."  He  was  but  twenty-nine 
years  old  at  the  time,  but  the  address  shows  a  breadth  of 
thought,  a  maturity  of  experience,  and  a  soundness  of 
argument  that  would  have  done  credit  to  his  riper  years. 
And  it  is  surprisingly  modern  in  its  observations  and  con- 
clusions. Its  advocacy  of  fresh  air,  cold  water,  and  exer- 
cise alone  gives  it  value,  to  say  nothing  of  the  admirable 
collection  of  facts  which  is  given  about  those  uncontami- 
nated  red  men  of  the  early  days. 

There  is  but  little  to  say,  however,  about  the  young 
practitioner  Rush  in  the  years  between  1769  and  1775. 
He  was  busy,  as  we  have  seen,  making  himself  known, 
acquiring  a  practice,  and  teaching;  but  the  one  great 
topic  of  the  day — the  rupture  with  England — was  rap- 
idly absorbing  him,  as  it  was  all  men  with  red  blood  in 
their  veins;  and,  like  Joseph  Warren  in  Boston,  he  threw 
himself  heart  and  soul  into  the  patriot  cause. 

The  importance  of  the  part  played  by  Rush  in  the  War 
of  the  Revolution  has  probably  been  somewhat  exag- 
gerated by  writers,  and  if  he  had  afterwards  remained 
undistinguished  his  patriotic  services  would  mostly  have 
been  forgotten.     Those  services  consisted  in  writing  fre- 


152 


MEDICINE    IN    AMERICA. 


quent  vigorous  essays  in  defence  of  the  position  taken  by 
his  country,  in  pubhc  speaking  to  the  same  effect  when 
occasion  offered,  in  serving  two  years  in  Congress,  in  ad- 
vocating and  signing  the  Declaration  of  Independence, 
and  in  acting  as  one  of  Shippen's  most  efficient  Heutenants 
for  a  year  or  more. 

In  regard  to  the  Declaration,  Rush  was  even  more  for- 
ward and  radical  than  most  of  his  friends.  Before  going 
to  Congress  he  had  been  a  member  of  the  Provincial  Con- 
ference of  Pennsylvania,  and,  with  James  Smith,  acted 
as  a  committee  to  consider  the  question  whether  it  were 
best  for  Congress  to  declare  independence.  The  com- 
mittee, in  a  report  evidently  composed  and  written  by 
Rush  himself,  strongly  urged  the  measure,  and  their  rea- 
soning prevailed.® 

This  report  of  Rush  anticipated  much  that  was  enun- 
ciated by  the  Declaration  itself;  so  that  when  Congress 
came  to  carry  out  that  important  measure,  he  found  him- 
self voting  practically  on  lines  of  his  own  making.  As 
Jackson  says,  he  did  not  sign  the  tremendous  parchment 
because  he  was  a  member;  he  became  a  member  that  he 
might  sign  it. 

In  that  same  year  (1776)  Rush  saw  his  first  army  ser- 
vice, being  appointed  surgeon-general  for  the  Middle 
Department  under  Shippen,  and  the  next  year  his  ap- 
pointment was  changed  to  that  of  physician-general.  Be 
it  remembered  that  at  the  time  of  his  holding  the  first 
position  he  was  but  thirty-one  years  old. 

In  that  year,  too,  he  took  to  himself  a  wife.  As  a 
younger  man  he  had  said,  as  so  many  had  said  before  him, 
that  he  should  never  marry;  that  marriage  unfitted  a 
man  for  serious,  sustained  professional  work.  He  was 
guilty  of  the  often-quoted  and  rather  silly  remark,  "  Medi- 


•  Journal  of  the   House  of  Representatives  of   Pennsylvania,   vol. 
vii.  p.  43-  * 


BENJAMIN   RUSH.  153 

cine  is  my  wife;  science  is  my  mistress;  books  are  my 
companions;   my  study  is  my  grave." 

However  all  that  may  have  been,  a  daughter  of  his  Con- 
gressional colleague,  Richard  Stockton,  of  New  Jersey, 
was  found  worthy  to  divide  with  medicine  and  science  a 
place  in  his  affections,  and  that,  too,  when  he  had  reached 
no  very  advanced  age.  They  were  married,  had  many 
children,  and  she  survived  him  many  years. 

After  two  years  of  marriage  and  military  life  Rush 
resigned  from  the  army,  and  in  that  action  the  candid  his- 
torian must  grieve  to  find  that  there  is  nothing  to  com- 
mend. The  chapter  is  obscure  and  difficult,  the  reasons 
given  inadequate  and  disappointing. 

It  was  in  February,  1778,  the  winter  of  Valley  Forge, 
that  Rush  left  the  service.  No  darker  time  for  the  Ameri- 
can arms  had  been  known.  Washington  was  keeping  up 
the  heart-breaking  struggle  against  want,  privation,  mu- 
tiny, desertion,  treacherous  friends,  open  enemies  in  Con- 
gress, a  neglected  commissariat,  an  empty  exchequer,  a 
public  confidence  partly  shaken  by  his  apparent  want  of 
success  compared  with  the  unmerited  triumph  of  Gates  at 
Saratoga,  when  Rush  took  it  upon  himself,  as  it  appears, 
to  leave  his  post  and  join  the  notorious  Conway  cabal. 
It  is  only  fair  to  say  that  this  attitude  towards  his  chief 
was  not  notably  conspicuous;  but  Washington  believed 
in  his  treachery,  and  even  his  eulogist,  Jackson,  makes  but 
a  feeble,  half-hearted  defence. 

Two  reasons,  almost  equally  unconvincing,  were  as- 
signed for  Rush's  resignation :  "  His  sense  of  duty  to  the 
soldiers  had  led  him  to  complain  of  wrongs  in  a  certain 
department ;  second,  there  arose  some  coldness  between 
him  and  the  Commander-in-Chief."  Just  what  useful 
purpose  to  the  soldiers  could  be  served  by  the  resignation 
of  their  accomplished  physician-general  at  the  very  time 
when  they  needed  him  most  it  is  rather  hard  to  see ;  and 
if  officers  are  to  leave  their  duties  in  times  of  trial  and  dis- 


154  MEDICINE    IN   AMERICA. 

tress,  on  account  of  the  coldness  of  the  commanding  gen- 
eral, it  will  go  hard  indeed  with  the  service. 

But  one  grows  indignant  with  the  man  for  his  obtuse- 
ness.  It  is  the  unanimous  verdict  of  fair-minded  con- 
temporaries that  no  intelligent  man  could  come  under  the 
immediate  influence  of  Washington  in  those  trying  years 
without  acquiring  an  absolute  confidence  in  his  extraor- 
dinary ability,  his  forcefulness,  his  almost  superhuman 
patience,  and  his  compelling  personality.  Yet  Rush  seems 
to  have  been  one  of  the  rare  exceptions.  He  was  an 
honest  man,  he  was  a  sincere  patriot,  he  looked  only  to  the 
good  of  the  cause,  he  had  nothing  to  gain,  and  yet  he 
acted  as  he  did. 

The  Conway  cabal  business  is  a  painful  episode.  There 
is  no  doubt  that  a  great  many  men  in  that  feeble  Congress 
of  1778  were  bitterly  jealous  of  Washington  and  pro- 
fessed to  fear  a  standing  army.  The  reputed  success  of 
Gates  "^  gave  such  men  the  opportunity  they  were  looking 
for,  and  the  cry  was  started  that  the  victorious  general 
should  be  put  at  the  head  of  the  Continental  armies.  Aside 
from  such  men  in  Congress,  there  were  others  of  note  who 
looked  on  from  a  distance;  and,  being  out  of  touch  with 
the  facts,  were  too  harshly  critical  of  the  chief.  John 
Adams  himself,  though  a  political  friend  of  Washington, 
knew  nothing  of  military  affairs,  and  exclaimed,  "  I  am 
weary  with  so  much  insipidity.  I  am  sick  of  Fabian  sys- 
tems in  all  quarters."  That  light-headed,  clever  poli- 
tician, Samuel  Adams,  was  of  the  same  mind ;  so,  too, 
was  the  unfortunate  Mifflin  and  the  two  dull,  unprofitable 
Englishmen,  Charles  Lee  and  Gates.  But  the  most  active 
and  unscrupulous  worker  of  them  all  was  a  hot-headed 
Irish  adventurer,  Conway,  who  hated  Washington  and 
had  his  own  ends  to  gain. 


^  History   has    shown    that,    in    tlic   operations    against    Burgoyne, 
Gates  had  a  very  insignificant  share. 


BENJAMIN   RUSH.  155 

The  Congress  had  a  stupid,  fatuous  notion  of  taking 
up  with  such  foreign  importations.  Lee  and  Gates  were 
obstinate,  bhistering,  wrong-headed  islanders,  out  of 
whom  commanders  could  never  have  been  made;  very- 
much  of  the  sort  which  British  reverses  in  South  Africa 
have  made  so  conspicuous  in  our  own  day,  whom  the 
world  has  come  to  look  upon  as  typical.  Conway  was  a 
feather-weight  person  out  for  mischief.  Mifflin  was  an 
able,  unscrupulous  politician,  with  blighted  military  ambi- 
tions. Congress  had  been  induced  to  favor  Conway  and 
Mifflin,  and  at  this  time  both  were  general  officers  looking 
for  preferment. 

Strange  as  it  seems  to  us  now.  Rush  w^as  an  ardent 
champion  of  these  two  shallow  persons;  but,  fortunately 
for  him  and  all  misguided  men,  the  bubble  burst  before 
any  great  harm  was  done. 

Underhand  means  were  taken  to  damage  Washington, 
and  Rush  seems  to  have  been  concerned  in  them.  Anony- 
mous letters  were  written,  and  the  cry  was  circulated  that 
under  a  Lee,  a  Gates,  or  a  Conway  the  Southern  army 
would  be  as  successful  as  the  Northern.  A  futile  attempt 
was  made  to  separate  Lafayette  from  Washington  by 
sending  him  to  Canada,  assisted  by  Conway,  on  a  wild- 
goose  chase,  but  this  project  failed.  Then  Wilkinson,  one 
of  Gates's  staff,  got  drunk,  on  occasion,  and  repeated  pub- 
licly the  purport  of  a  letter  which  Conway  had  written  to 
Gates :  "  Heaven  has  been  determined  to  save  your  coun- 
try or  a  weak  general  and  bad  counsellors  would  have 
ruined  it."  The  words  were  conveyed  to  Washington, 
who  enclosed  them  to  Conway.  Thus  exposed,  the  men 
concerned  attempted  to  bluster  it  out;  but,  unfortunately 
for  themselves,  they  had  rashly  submitted  the  correspond- 
ence to  Congress,  and  that  body,  in  an  access  of  intelli- 
gence, investigated  the  whole  matter  under  dispute,  found 
itself  obliged  to  balk  the  cabal,  and,  for  very  shame,  came 
to  the  aid  of  Washington  and  his  distressed  army. 


156  MEDICINE    IN   AMERICA. 

How  active  Rush  may  have  been  in  all  this  exasperating 
business  it  is  hard  to  say;  but  one  anonymous  letter  to 
Patrick  Henry,  then  Governor  of  Virginia,  has  been  given 
to  us  by  Marshall,  and  we  are  told  that  Washington 
always  credited  Rush  with  its  authorship.^ 


^"  (copy.) 

"  York  town,  January  12,  1778. 
"  Dear   sir, 

"  The  common  danger  of  our  country  first  brought  you  and  me 
together.  I  recollect  with  pleasure  the  influence  of  your  conver- 
sation and  eloquence  upon  the  opinions  of  this  country  in  the  be- 
ginning of  the  present  controversy.  You  first  taught  us  to  shake 
off  our  idolatrous  attachment  to  royalty,  and  to  oppose  its  encroach- 
ments upon  our  liberties  with  our  very  lives.  By  these  means 
you  saved  us  from  ruin.  The  independence  of  America  is  the 
offspring  of  that  liberal  spirit  of  thinking,  and  acting,  which  fol- 
lowed the  destruction  of  the  spectres  of  kings  and  the  mighty  power 
of  Great  Britain. 

"  But,  sir,  we  have  only  passed  the  Red  Sea.  A  dreary  wilderness 
is  still  before  us,  and  unless  a  Moses  or  a  Joshua  are  raised  up  in 
our  behalf,  we  must  perish  before  we  reach  the  promised  land.  We 
have  nothing  to  fear  from  our  enemies  on  the  way.  General  Howe, 
it  is  true,"  has  taken  Philadelphia;  but  he  has  only  changed  his 
prison.  His  dominions  are  bounded  on  all  sides  by  his  outsentries. 
America  can  only  be  undone  by  herself.  She  looks  up  to  her  coun- 
cils and  arms  for  protection;  but  alas!  what  are  they?  her  repre- 
sentation in  congress  dwindled  to  only  twenty-one  members  .  .  . 
her  Adams  .  .  .  her  Wilson  .  .  .  her  Henry,  are  no  more  among 
them.  Her  councils  weak  .  .  .  and  partial  remedies  applied  con- 
stantly for  universal  diseases.  Her  army  .  .  .  what  is  it?  a  major 
general  belonging  to  it  called  it  a  few  days  ago  in  my  hearing  a 
mob.  Discipline  unknown  or  wholly  neglected.  The  quarter  master 
and  commissary's  departments  filled  with  idleness,  ignorance  and 
peculation  .  .  .  our  hospitals  crowded  with  six  thousand  sick,  but 
half  provided  with  necessaries  or  accommodations,  and  more  dying 
in  them  in  one  month,  than  perished  in  the  field  during  the'  whole 
of  the  last  campaign. 

"  The  money  depreciating  without  any  effectual  measures  being 
taken  to  raise  it  .  .  .  the  country  distracted  with  the  don  Quixotte 
attempts  to  regulate  the  prices  of  provisions,  an  artificial  famine 
created  by  it,  and  a  real  one  dreaded  from  it.  The  spirit  of  the 
people  failing  through  a  more  intimate  acquaintance  with  the  causes 
of  our  misfortunes  .  .  .  many  submitting  daily  to  general  Howe 
and  more  wishing  to  do  it,  only  to  avoid  the  calamities  which 
threaten  our  country.     But  is  our  case  desperate?     By  no  means. 


BENJAMIN    RUSH.  157 

It  is  comfortable  for  one  who  admires  the  man  to  get 
past  that  episode  in  his  career.  The  friendhest  critic  must 
call  Rush's  action  an  error  in  judgment;  so  with  a  mere 
error  in  judgment  let  him  stand  accused. 

Before  leaving  the  army,  however,  Rush  emphasized 
his  admirable  medical  services  by  publishing  a  pamphlet 
embodying  his  observations  on  the  soldiers'  diseases.  The 
article  was  reprinted  and,  when  distributed,  became  a 
standard  authority  of  great  value  among  Revolutionary 
surgeons. 

After  his  rather  ignominious  exit  from  military  service 
Rush  returned  to  Philadelphia  and  a  successful  practice. 
Morgan  was  there  before  him  after  his  unmerited  dismis- 
sal by  Congress,  but  Shippen  still  kept  the  field.  From 
that  year  forward,  then,  we  must  regard  Rush  as  teacher, 
writer,  and  practitioner, — a  politician  incidentally, — and 
learn  in  what  way  he  came  at  last  to  be  the  great  medical 
prophet  of  America. 

Even  during  his  busy  and  absorbing  professional  labors 


We  have  wisdom,  virtue,  and  strength  eno'  to  save  us  if  they  could 
be  called  into  action.  The  northern  army  has  shown  us  what 
Americans  are  capable  of  doing  with  a  GENERAL  at  their  head. 
The  spirit  of  the  southern  army  is  in  no  ways  inferior  to  the  spirit 
of  the  northern.  A  Gates  ...  a  Lee,  or  a  Conway  would,  in  a  few 
weeks,  render  them  an  irresistible  body  of  men.  The  last  of  the 
above  officers  has  accepted  of  the  new  office  of  inspector  general 
of  our  army,  in  order  to  reform  abuses  .  .  .  but  the  remedy  is 
only  a  palliative  one.  In  one  of  his  letters  to  a  friend  he  says,  '  a 
great  and  good  God  hath  decreed  America  to  be  free  ...  or  the 
.  .  .  and  weak  counsellors  would  have  ruined  her  long  ago  .  .  . 
you  may  rest  assured  of  each  of  the  facts  related  in  this  letter. 
The  author  of  it  is  one  of  your  Philadelphia  friends.  A  hint  of 
his  name,  if  found  out  by  the  hand  writing,  must  not  be  mentioned 
to  your  most  intimate  friend.  Even  the  letter  iniist  be  thrown  in 
the  fire.  But  some  of  its  contents  ought  to  be  made  public  in  order 
to  awaken,  enlighten,  and  alarm  our  country.  I  rely  upon  your 
prudence,  and  am,  dear  sir,  with  my  usual  attachment  to  you,  and 
to  our  beloved  independence, 

"  Yours,  sincerely. 
"  His  excellency  P.  Henry." 


158  MEDICINE    IN    AMERICA. 

Rush  could  not  divorce  liimself  entirely  from  the  larger 
interests  of  his  country.  He  was  made  a  member  of  the 
Convention  of  Pennsylvania  for  the  adoption  of  the  Fed- 
eral Constitution  ten  years  after  he  had  left  the  army,  and 
during  the  last  fourteen  years  of  his  life  he  was  Treasurer 
of  the  United  States  Mint. 

All  through  his  life  he  was  vigorously  democratic  in 
his  feelings  and  expressions;  indeed,  he  anticipated  by 
many  generations  several  great  social  reforms.  He  cham- 
pioned the  emancipation  of  slaves,  as  we  have  seen ;  he 
was  opposed  to  the  death  penalty,  even  for  murder;  he 
reprobated  all  forms  of  corporal  punishment;  he  was  an 
eloquent  advocate  of  the  higher  education  of  women ;  and, 
long  before  Jacob  Bigelow,  he  preached  the  disadvantages 
of  the  old-fashioned  classical  education  and  the  value  of 
English  studies,  the  modern  languages,  and  thorough  tech- 
nical training.  He  also  believed  in  the  possibility  of  the 
abolition  of  war  and  the  substitution  for  it  of  some  form 
of  arbitration.  What  he  proposed  was  the  appointment  of 
a  cabinet  officer  who  should  be  called  The  Secretary  of 
State  for  Peace.  This  functionary  should  control  the 
public  schools  and  direct  an  educational  crusade  against 
militarism;  he  should  abolish  the  militia  and  all  military 
dress  and  titles.  The  folly  of  all  the  trappings  of  war 
should  be  drilled  into  the  new  generation,  and  he  hoped 
that  in  the  course  of  years  war  would  become  as  obsolete 
and  preposterous  as  the  mediaeval  trial  by  battle.  He  does 
not  seem  to  have  gone  so  far  as  to  propose  an  international 
peace  tribunal,  such  as  we  have  seen  attempted  in  these 
latter  days;  he  meant  to  begin  in  a  humbler  way  at  the 
foundation  and,  by  educating  a  whole  people  to  a  hatred  of 
war,  to  lead  the  other  nations  gradually  and  by  force  of 
example  to  a  similar  frame  of  mind  and  policy. 

This  agreeable  plan  he  seems  to  have  thought  practical, 
but  he  evidently  took  very  little  stock  in  the  elemental  evo- 
lutionary forces  which  so  largely  control  human  affairs. 


BENJAMIN    RUSH.  159 

It  was  a  pleasant  Utopia  and  pleasantly  planned,  but  as 
yet  the  world  heard  him  with  an  impatient  shrug. 

So,  too,  with  his  antislavery  propaganda.  He  foresaw 
truly  the  horrors  and  the  future  misery  which  "  the  sys- 
tem" had  in  store  for  his  people,  but  he  proposed  no  very 
practical  solution  of  the  problem.  He  wrote  a  pretty 
story, — "  A  Paradise  of  Slaves," — telling  of  a  dream  in 
which  he  met  former  slaves  translated  to  a  region  of  per- 
fect happiness,  where  many  of  them  related  to  him  their 
experiences  on  earth.  These  tales  w^ere  obviously  founded 
on  well-known  facts,  and  the  many  horrors  described  are 
said  to  have  greatly  impressed  his  readers. 

Such  were  some  of  the  thoughts,  political  and  social, 
which  occupied  Rush's  mind  when  he  returned  to  practice 
in  Philadelphia ;  and  the  kindly  philosophizings  were  often 
and  fearlessly  expressed  even  in  the  midst  of  his  more 
engrossing  work. 

Medical  teaching  in  Philadelphia  had  been  discontinued 
while  the  city  was  occupied  by  the  British,  but  about  the 
time  of  Rush's  return  lectures  were  again  taken  up,  and 
in  the  autumn  of  1778  the  Medical  School  opened  with  a 
class  of  sixty.  For  another  year  the  work  went  on,  and 
then,  in  November,  1779,  the  College  charter  was  revoked, 
as  has  been  recorded,  and  the  University  of  the  State  of 
Pennsylvania  was  established.  Rush  agreed  with  his  col- 
leagues as  to  the  injustice  which  had  been  done, but  in  1781 
he  joined  Shippen  at  the  University  School  and  gave  the 
lectures  on  chemistry.  Then  in  1 783  he  came  back  to  the 
chair  of  Chemistry  in  the  restored  College,  where  he  re- 
mained until  1789,  when,  upon  the  death  of  Morgan,^  he 

"  To  the  student  of  medical  biography  it  is  interesting  to  remem- 
ber that,  on  taking  the  chair  as  Morgan's  successor,  Rush  devoted 
most  of  his  introductory  lecture  to  a  memorial  of  his  predecessor. 
This  memoir  is  published  in  the  Philadelphia  Medical  and  Physical 
Journal,  vol.  i.,  and  is  almost  our  only  source  of  information  re- 
garding the  life  of  the  distinguished  founder  of  the  Philadelphia 
School. 


i6o  MEDICINE    IN    AMERICA. 

succeeded  him  as  Professor  of  the  Theory  and  Practice  of 
Medicine.  Finally,  in  1791,  when  the  two  schools  were 
united  in  the  University  of  Pennsylvania,  he  was  appointed 
to  the  chair  of  The  Institutes  of  Medicine  and  Clinical 
Medicine.  The  chair  of  Practice  was  taken  by  Adam 
Kuhn,  who  held  it  until  1797,  when  Rush  added  that,  too, 
to  his  other  labors,  though  not  formally  elected  to  the  posi- 
tion until  1805.  After  that  he  continued  the  triple  burden 
until  his  death. 

So  we  begin  to  get  some  idea  of  the  magnitude  of  his 
labors.  Two  sets  of  lectures,  clinical  talks,  an  arduous 
service  at  the  Pennsylvania  Hospital,  a  daily  routine  prac- 
tice never  shirked,  constant  and  often  distant  consulta- 
tions, a  voluminous  correspondence,  public  lectures  and 
their  preparation,  omnivorous  reading,  essay  writing  and 
publishing,  the  inevitable  interruptions  that  came  to  him 
as  a  quasi-public  man,  the  cares  of  a  large  family, — these 
were  some  of  his  duties  in  life.  He  performed  them  punc- 
tually, exactly,  without  haste,  thoroughly.  His  health  was 
not  of  the  best,  but  he  conserved  it ;  his  life  was  not  with- 
out sorrow,  but  he  bore  it  as  a  philosopher  should;  and 
at  the  end  we  have  heard  him  regret  heaven  because  there 
would  be  no  practice  there.  It  is  hard  not  to  fall  into 
eulogy.  We  all  love  the  man  who  stands  up  to  his  work 
and  takes  without  a  whimper  what  comes  to  him.  Here 
surely  was  such  a  one. 

Rush's  teaching  was  supplemented  l)y  his  writing,  and 
of  his  writing  it  is  difficult  to  say,  briefly  and  fully,  the 
final  word  in  a  few  pages. 

In  his  early  life  he  was  a  disciple  of  Cullen,  but  before 
long  he  began  to  see  the  fallacies  of  his  old  Edinburgh 
master,  who  has  been  called  the  "  father  of  modern  solid- 
ism."  In  Cullen's  system,  phenomena  were  attributed  to 
conditions  of  the  body's  solids,  the  nerves  being  the  chief 
agents;  but  he  is  best  remembered  for  his  nosology,  which 
arbitrarily  divided  pathological  processes  into  many  hun- 


BENJAMIN   RUSH.  i6i 

dreds  of  species  and  genera,  like  the  classification  of 
plants,  and  found  an  appropriate  method  of  treatment  for 
each.  Those  teachings  of  Cullen  sound  absurd  enough 
to-day,  but  the  genius  of  the  master  raised  them  to  a  very 
great  popularity  in  Rush's  youth,  and  many  years  were 
spent  in  threading  their  intricacies. 

Later,  Rush  was  attracted  by  the  theories  of  John 
Brown,  Cullen's  pupil,  rival,  and  enemy.  He  gave  much 
attention  to  the  Brunonian  philosophy,  making  the  "  The- 
ory of  Life"  available  in  the  construction  of  a  new  sys- 
tem. That  Scotch  physiologist  distinguished  only  two 
pathological  states :  one  consisting  in  an  excess  of  incita- 
bility,  which  he  names  the  "  sthenic  diathesis ;"  the  other 
constituted  by  a  want  of  the  same  faculty,  which  is  the 
"  asthenic  diathesis."  After  having  reduced  all  diseases  to 
two  genera  and  withdrawn  from  pathology  the  study  of 
local  lesions.  Brown  shows  to  his  own  satisfaction  that  the 
sthenic  order  is  very  small,  the  asthenic  or  feeble,  debili- 
tated order  very  great  or  almost  universal,  with  the  result 
that  nearly  all  diseases  must  be  met  by  stimulating.  It 
was  an  easy,  pleasant  doctrine  and  made  alcohol  the  sum- 
mum  honum. 

Now,  neither  of  these  two  theories — the  one  complex, 
the  other  simple — was  accepted  by  Rush,  though  writers, 
even  of  our  own  day,  constantly  call  him  a  Brunonian. 
He  did,  indeed,  abandon  the  clumsy,  voluminous  nomen- 
clature of  Cullen  to  follow  a  simplified  method,  but  he 
never  accepted  Brown's  proposition  that  nearly  all  condi- 
tions needed  but  stimulation.  Indeed,  if  Rush  stood  for 
any  one  thing,  it  was  a  return  to  normal  conditions, — a 
wholesome  hygienic  life,  air,  water,  exercise,  and  the  vis 
medicatrix  natures.  He  added  to  that  the  over  use  of  cer- 
tain drugs  and  he  championed  bleeding,  but  to  no  such 
extent  as  some  of  his  followers  proclaimed.  A  pardonable 
error  of  which  he  was  guilty  was  constantly  to  confuse 
symptoms  with  diseases, — an  error  universal  in  his  day, — 


1 62  MEDICINE    IN    AMERICA. 

and  so  to  build  up  a  series  of  therapeutic  propositions 
which  only  his  own  sound  sense  and  great  experience 
could  control. 

His  syllabus  is  full  of  interesting  information  more  or 
less  erroneous  to  us  with  our  better  knowledge.  Inflam- 
mation had  been  called  a  disease;  he  called  it  an  effect  of 
disease,  error  loci,  red  blood  in  serous  vessels ;  hence,  as 
one  of  his  eulogists  says,  "  he  escaped  all  the  self-torment- 
ing unprofitable  folly  of  inquiring,  what  is  inflamma- 
tion?— a  question  that  can  never  be  answered.  To  go 
behind  this  error  loci,  inquiring  into  the  mysteries  of  the 
formal  cause  must  forever  be  vain;  as  well  might  you 
inquire,  as  Xewton  vainly  did,  what  is  the  cause  of  at- 
traction and  repulsion?" 

These  words  of  Samuel  Jackson,  written  some  forty 
years  ago,  already  beg  an  apology  for  the  apologist.  Rush 
fell  into  the  error  of  so  many  other  system-builders,  and, 
confusing  cause  with  effect,  asserted  that  inflammation 
was  the  result  of  fever. — an  assertion  which  Jackson  in- 
dorses. 

"  He  had  learned  from  a  French  writer  two  words, — 
Centrifugal  and  Centripetal;  hence  all  his  hopes  in 
Yellow  Fever,  and  other  Centripetal  diseases,  were 
placed  in  timely  depletion  or  revulsion  or  in  changing  the 
deadly  excitement  by  mercury. 

"  Here  is  one  of  the  diseases  in  which  the  physician 
is  master,  his  reason  directing;  nature  is  the  servant, 
acting  bv  necessity  and  of  herself  doing  nothing  but  mis- 
chief." ' 

At  the  time  of  his  succeeding  Morgan,  in  1789,  Rush 
wrote  Ramsay  that  "  the  system  of  Cullen  was  tottering ; 
that  Brown  had  brought  forward  some  luminous  princi- 
ples, but  mixed  with  others  that  were  extravagant,  and 
that  he  saw  a  gleam  of  light."  He  then  proceeded  to  that 
consideration  of  the  Brunonian  system  which  led  to  his 
inquiry  into  the  cause  of  life,  and  finally  to  another  doc- 


BENJAMIN    RUSH.  163 

trine, — not,  however,  a  necessary  consequence  of  it, — tlic 
unity  of  disease.  Excitement  or  life  is  a  unit,  and  this 
can  be  accurately  divided  into  healthy  and  morbid  only; 
hence  there  can  be  but  one  disease,  morbid  excitement. 
Then  he  goes  on  to  describe  six  primary  forms  of  this 
unit. — spasm,  convulsion,  heat,  itching,  aura  dolorifica. 
and  suffocated  excitement.  It  is  aU  profitless  enough,  but 
it  is  interesting  to  watch  how  this  really  able  man  wan- 
dered away  even  from  the  science  which  the  best  of  his 
own  day  were  already  grasping,  and  involved  himself  in 
nebulous  contradictions;  for  after  his  premise  of  the 
unity  of  disease  he  actually  winds  up  in  the  absurdity  of 
describing  manifold  diseases  most  accurately  and  exactly. 

Rush  did  one  excellent  work  in  teaching  that  general 
debility  predisposes  to  disease,  and  in  tliis  he  dift'ered 
from  Brown,  who  held  that  the  debility  was  part  of  the 
disease  itself. 

One  of  Rush's  most  famous  essays  was  on  "  The  In- 
fluence of  Physical  Causes  on  the  iNIoral  Faculty."  read 
before  the  Philosophical  Society  of  Philadelphia,  the 
President  of  tlie  State,  the  Supreme  Council,  and  the 
members  of  the  General  Assembly.  He  defines  the  moral 
faculty  as  a  power  in  the  himian  mind  of  distinguishing 
and  choosing  good  and  evil.  "  It  is  a  native  principle,  and 
though  it  is  capable  of  improvement  by  experience  and 
reflection,  it  is  not  derived  from  either."  '''  This  faculty 
is  often  confounded  with  conscience."  "The  moral  faculty 
performs  the  ofHce  of  a  law-giver,  while  the  business  of 
conscience  is  to  perform  tlie  dtity  of  a  judge.''  "  The 
moral  faculty  is  to  the  conscience  what  taste  is  to  the 
judgment  and  sensation  to  perception."  The  total  ab- 
sence of  the  moral  faculty  he  styles  Ano)nia;  the 
weakened  action  of  it  Micronomia.  Thence  he  studies 
the  influence  upon  it  of  various  physical  causes :  climate, 
diet,  certain  drinks,  excessive  sleep,  bodily  pain,  cleanli- 
ness, solitude,  silence,  music,  eloquence  of  the  pulpit,  odors 


1 64  MEDICINE    IN   AMERICA. 

of  various  kinds,  light  and  darkness,  medicines,  irritation, 
habit,  association,  sensibihty,  cruelty,  attraction,  composi- 
tion, decomposition,  each  of  which  influences  is  itself 
made  a  subject  of  study.  The  essay  winds  up  with  a  fine 
tribute  to  Benjamin  Franklin,  a  man  "  who  appears  to 
have  been  lent  to  mortals  on  purpose  to  render  our  globe 
a  more  convenient  and  safe  habitation  for  the  children  of 
men." 

Doubtless  the  most  conspicuous  of  Rush's  publications 
and  the  work  on  which  (mainly)  his  fame  rested  is  "  i\n 
Account  of  the  Bilious  Yellow  Fever,  as  It  Appeared  in 
Philadelphia  in  1793."  It  fills  two  hundred  and  eighty- 
six  pages  of  the  third  volume  of  his  collected  works  and 
is  certainly  a  wonderful  production.  Indeed,  the  last 
chapter  alone,  in  which  Rush  describes  his  own  sensations 
during  the  epidemic  year,  is  a  masterpiece  of  realism,  con- 
sidering the  formal  times  in  which  it  was  written.  The 
book  circulated  immediately  throughout  Europe,  and  was 
translated  into  three  languages.  Trotter  called  it  "  the 
best  history  that  was  ever  written  of  an  epidemic.  Who 
would  not  travel  through  this  vale  of  tears,  amidst  blasts 
of  contagion,  to  share  the  well-earned  fame  of  Dr.  Rush?" 

Zimmermann  said  that  "  he  merited  a  statue  not  only 
from  Philadelphia  but  from  all  humanity;"  and  Lettsom 
states  "  that  all  Europe  was  astonished  at  his  novelty  and 
bold  decision,  his  unprecedented  sagacity  and  judgment." 

This  essay  and  some  few  others  of  Rush's  writings  have 
been  hinted  at.  The  field  he  covered  was  truly  almost 
encyclopedic,  and  a  list  of  his  subjects  is  given  at  the  end 
of  this  chapter.  Most  of  the  writing  was  well  done, — not 
hasty,  for  his  teeming  note-books  supplied  him  with  an 
abundance  of  carefully  gathered  material ;  and  the  man 
among  us  who  wishes  to  devote  his  leisure  moments  to  a 
more  careful  survey  of  the  volumes  will  find  in  them  a 
goodly  supply  of  modern  thought  as  well  as  a  delightful 
story  of  the  medical  problems  of  a  hundred  years  ago. 


BENJAMIN    RUSH.  165 

Richardson  says,  "  In  his  character  of  Physician  we 
may  look  upon  Rush  as  a  healer,  a  Sanitarian,  an  Ora- 
tor, a  Man  of  Letters  and  a  Teacher.  Within  the  strict 
lines  of  the  accomplished  Physician  he  was  remarkably 
Conspicuous  in  all  these  departments." 

The  most  important  year  in  Rush's  life,  after  the  end 
of  the  Revolution,  was  1793.  He  was  then  forty-eight 
years  old,  just  reaching  the  high  tide  of  his  work,  full  of 
energy,  zeal,  and  courage,  and  never  more  ready  to  take 
hold  of  the  opportunity  offered  him  by  the  great  yellow 
fever  epidemic  of  that  year.  Up  to  that  time,  although  well 
known  to  the  profession  and  one  of  the  strong  men  of 
the  Pennsylvania  School,  his  fame  had  by  no  means  be- 
come national,  and  he  was  unknown  in  the  Old  World. 
Besides  Rush's  own  story  of  the  epidemic,  we  have  the 
graphic  description  by  Mathew  Carey,  which  supplements 
admirably  the  more  famous  account. 

At  the  time  of  the  outbreak  Rush  held  that  yellow  fever 
was  contagious,  that  it  might  and  did  arise  from  ill-kept 
houses  and  foul  odors,  and  was  not  imported.  The  for- 
mer of  these  two  beliefs  he  frankly  abandoned  later,  being 
convinced,  as  modern  science  has  conclusively  proved, 
that  personal  contact  does  not  convey  the  disease;  but 
he  clung  to  the  belief  that  it  might  and  did  arise  spon- 
taneously in  Philadelphia,  and  for  this  he  was  submitted 
to  one  of  the  bitterest  medical  persecutions  in  our  history. 

The  cases  began  to  be  reported  in  August  and  did  not 
disappear  until  the  advent  of  frost  in  October.  The  mor- 
tality during  those  three  months  was  four  thousand  and 
forty-one,  of  whom  three  thousand  four  hundred  and 
thirty-five  died  in  September  and  October,  after  the  dis- 
ease had  gathered  full  headway.  The  population  of  Phila- 
delphia at  that  time  was  forty  thousand ;  and,  as  probably 
a  fourth  part  had  fled  from  the  city,  it  is  fair  to  say  that, 
of  those  actually  in  residence,  ten  per  cent,  perished  in  the 
space  of  two  months. 


1 66  MEDICINE   IN   AMERICA. 

Ramsay  says,  "  the  year  1793  brought  the  theories  and 
the  native  strength  of  Dr.  Rush's  genius  to  the  test,"  and 
in  a  sense  he  is  correct.  At  that  time  no  infectious  dis- 
ease had  been  studied  in  the  sense  that  we  understand  the 
term,  if  we  except  smallpox,  and  thirty-one  years  had 
elapsed  since  yellow  fever  had  shown  itself  in  Philadel- 
phia. The  profession  mostly  was  ignorant  of  it,  except 
in  theory.  Rush  and  a  few  of  the  older  men  could  recall 
the  last  visitation,  but,  save  for  the  crude  therapeutics 
of  that  earlier  era,  they  were  ignorant  how  to  meet  it. 
Indeed,  when  Rush  startled  the  community  by  announcing 
its  presence  and  how  it  must  be  distinguished  from  the 
ordinary  "  bilious  fever,"  he  was  met  with  sharp  denial 
and  reproach.  However,  the  authorities  directed  the 
health  officer,  James  Hutchinson,  to  investigate,  and  he 
shortly  reported  that  the  disease  was  undoubtedly  present 
and  that  forty  ^^  persons  had  already  died  of  it.  This  w^as 
about  four  weeks  after  the  appearance  of  the  first  case. 
Various  explanations  of  the  fever's  appearance  were  forth- 
coming. It  was  at  first  supposed  to  have  been  brought  by 
a  vessel  from  Cape  Francais,  but  the  surgeon  of  the  ship 
so  vehemently  denied  any  sickness  on  board  that  this  most 
probable  explanation  was  abandoned,  and  the  theory  of 
Rush  and  Hutchinson  was  generally  accepted, — namely, 
that  a  mass  of  decaying  coffee  and  old  hides  thrown  out 
on  a  wharf  had  given  rise  to  so  foul  a  stench  as  to  breed 
the  disease.  Indeed,  after  this  filth  had  been  destroyed 
it  was  still  asserted,  with  much  wagging  of  heads,  that  the 
odor  persisted  and  continued  to  propagate  the  fever.  Of 
course  our  present  knowledge  of  the  Stegomyia  teniata, 
as  the  host  of  the  yellow  fever  organism,  was  not  dreamed 
of  for  nearly  ninety  years  —  that  busy  mosquito  still 
roamed  unquestioned  by  the  doctors ;   but  it  is  surprising 


"  Rush   asserted   that   the   number   at    this   time   was   nearer   one 
hundred  and  fifty. 


BENJAMIN   RUSH.  167 

that  so  acute  a  mind  as  Rush's  should  have  accepted  the 
spontaneous  generation  idea  and  forced  it  down  the 
throat  of  an  unwilhng  pubhc. 

But  whatever  the  theory  of  its  cause,  prompt  and  wise 
measures  were  taken  by  the  authorities,  acting  under  the 
advice  of  the  profession,  to  meet  the  epidemic.  At  a  meet- 
ing held  on  August  25  the  following  broadsheet  was  issued 
by  the  College : 

"  Philadelphia,  August  26,  1793. 

"  The  college  of  physicians  having  taken  into  consid- 
eration the  malignant  and  contagious  fever  that  now 
prevails  in  this  city,  have  agreed  to  recommend  to  their 
fellow  citizens  the  following  means  of  preventing  its 
progress. 

"  I  St.  That  all  unnecessary  intercourse  should  be 
avoided  with  such  persons  as  are  infected  by  it. 

"  2nd.  To  place  a  mark  upon  the  door  or  window  of 
such  houses  as  have  any  infected  persons  in  it. 

"  3d.  To  place  the  persons  infected  in  the  centre  of 
large  and  airy  rooms,  in  beds  without  curtains,  and  to  pay 
the  strictest  regard  to  cleanliness,  by  frequently  changing 
their  body  and  bed  linen,  also  by  removing,  as  speedily 
as  possible,  all  offensive  matter  from  their  rooms. 

"  4th.  To  provide  a  large  and  airy  hospital  in  the 
neighborhood  of  the  city,  for  the  reception  of  such  poor 
persons  as  cannot  be  accommodated  with  the  above  ad- 
vantages in  private  houses. 

"  5th.  To  put  a  stop  to  the  tolling  of  bells. 

"  6th.  To  bury  such  persons  as  die  of  this  fever,  in 
carriages,  and  in  as  private  a  manner  as  possible. 

"  7th.  To  keep  the  streets  and  wharfs  of  the  city  as 
clean  as  possible. — As  the  contagion  of  the  disease  may  be 
taken  into  the  body  and  pass  out  of  it,  without  producing 
the  fever,  unless  it  be  rendered  active  by  some  occasional 
cause,  the  following  means  should  be  attended  to,  to  pre- 
vent the  contagion  being  excited  into  action  in  the  body. 


i68  MEDICINE    IX    AMERICA. 

"  8th.  To  avoid  all  fatigue  of  body  and  mind. 
"  9th.  To  avoid  standing  or  sitting  in  the  sun;   also  in 
a  current  of  air,  or  in  the  evening  air, 

"  loth.  To  accommodate  the  dress  to  the  weather;  and 
to  exceed  rather  in  warm  than  in  cool  clothing. 

"  nth.  To  avoid  intemperance,  but  to  use  fermented 
liquors,  such  as  wine,  beer,  and  cyder,  in  moderation. 

"  The  college  conceives  fires  to  be  very  ineffectual,  if 
not  dangerous  means  of  checking  the  progress  of  this 
fever.  They  have  reason  to  place  more  dependence  upon 
the  burning  of  gun-pozi'der.  The  benefits  of  vinegar  and 
camphor  are  confined  chiefly  to  infected  rooms,  and  they 
cannot  be  used  too  frequently  upon  handkerchiefs,  or  in 
smelling  bottles,  by  persons  whose  duty  calls  them  to  visit 
or  attend  the  sick. 

"  Signed  by  order  of  the  college, 

"  William  Shippen,  Jun., 

"  Vice-President. 
"  Samuel  P.  Griffitts, 

''  Secretary." 

By  this  time  the  disease  was  well  started  and  its  exist- 
ence unquestioned.  Almost  no  class  in  the  community 
was  spared,  though  for  a  time  Rush  held  that  negroes 
were  immune  and  that  butchers,  house-painters,  grave- 
diggers,  and  scavengers  were  rarely  afflicted.  In  the  end, 
and  most  unfortunately  for  those  reputed  immunes,  since 
they  had  volunteered  to  attend  the  sick,  it  was  found  that 
all  men  fared  alike.  Soon  the  panic  became  universal. 
Those  who  could,  fled  from  the  city,  the  well  shunned  the 
sick,  the  sick  gave  themselves  up  for  lost,  the  supply  of 
nurses  and  physicians  failed,  and  the  terror  increased 
when  it  became  apparent  that  the  wretched  doctors  them- 
selves knew  not  what  to  do.  For  many  weeks  the  weather 
continued  hot  and  sultry,  adding  to  the  misery  of  existence 
and  stimulating  the  spread  of  the  fever.     It  became  ap- 


BENJAMIN    RUSH.  169 

parent,  too,  that  a  previous  attack  was  no  safeguard,  for 
Rush  reported  a  number  of  fresh  cases  in  persons  whom 
he  himself  had  attended  in  the  epidemic  of  1762.  This 
present  outbreak  proved  to  be  far  fiercer  than  the  last. 
It  spread  more  rapidly  and  ran  much  longer,  many  more 
persons  were  attacked,  and  the  mortality  was  far  higher. 

Like  the  rest  of  the  profession,  Rush  was  at  his  wits' 
end,  and  it  is  interesting  to  note  how  different  from  mod- 
ern methods  were  the  means  adopted  by  such  men  for 
solving  the  problem  of  treatment.  In  these  days  the  nat- 
ural history  of  a  disease  is  worked  up,  its  pathological 
anatomy  investigated,  and  clinical  and  laboratory  re- 
searches elaborately  and  carefully  made  in  order  to  learn 
the  exact  nature  of  the  phenomena  under  discussion  and 
so,  perchance,  to  find  an  appropriate  and  rational  remedy. 
Those  ancient  men,  on  the  contrary,  had  their  precon- 
ceived notions  as  to  the  nature  of  the  disease,  and  lim- 
ited themselves  mainly  to  searching  the  literature  of  the 
subject  and  to  experimenting  with  drugs. 

It  was  by  some  such  means  as  this  that  Rush  hit  upon 
what  he  ever  after  believed  was  the  panacea  for  yellow 
fever.  For  weeks  he  studied  the  records  and  found  count- 
less remedies,  all  of  which  failed  in  his  hands.  At  length, 
among  his  manuscripts,  he  lit  upon  that  old  essay,  written 
fifty  years  before  by  John  Mitchell,  of  Virginia,  describing 
the  fever  as  it  prevailed  there  in  1740  and  succeeding 
years.  The  paper  had  found  its  way  to  the  hands  of 
Franklin,  who  had  passed  it  on  to  Rush,  and  it  had  long 
lain  forgotten.  In  it  Rush  found  this  statement :  "  that 
evacuation  by  purges  was  more  necessary  in  this  than  most 
other  fevers  and  that  an  ill-timed  scrupulousness  about 
the  weakness  of  the  body  was  of  bad  consequence  in  these 
urging  circumstances."  "  I  can  affirm  that  I  have  given 
a  purge  in  this  case  when  the  pulse  has  been  so  low  that 
it  could  hardly  be  felt  and  the  debility  extreme ;  yet  both 
one  and  the  other  have  been  restored  by  it."    These  were 


I70  MEDICINE   IN   AMERICA. 

the  words  Rush  wanted  and  to  these  he  pinned  his  faith. 
They  fitted  in  well  with  his  own  notions  of  the  nature  of 
fever,  and  he  thought  he  saw  that  the  debility  indicated 
by  the  low  pulse  was  due  to  the  "  oppressed  state  of  the 
system,"  which  must  be  relieved  by  purging,  supple- 
mented by  bleeding.  Here  was  the  theory  and  here  were 
the  remedies  ready  made  to  fit  all  fevers.  Rush  seized 
upon  and  exploited  them.  They  became  a  strong  staff  in 
his  hands.  He  taught  them  eagerly  and  employed  them 
freely,  and  so  great  were  his  eloquence  and  zeal  that  for 
two  generations  he  remained  the  prophet  and  his  words 
prevailed. 

For  the  business  immediately  in  hand  he  was  equipped, 
and  he  proceeded  to  employ  Alitchell's  principles.  Calo- 
mel was  his  sheet-anchor.  Calomel  and  jalap  in  ten-  and 
fifteen-grain  doses,  repeated  frequently,  became  the  rou- 
tine, and  the  effect  far  exceeded  his  expectations.  He  is 
said  to  have  cured  the  first  four  patients  on  whom  he  tried 
it.  Then  he  told  his  discovery  to  his  friends.  He  in- 
structed doctors,  nurses,  apothecaries,  and  the  public.  It 
was  a  great  procedure  and  was  instantly  adopted  by  his 
disciples.  His  own  sublime  faith  in  the  treatment  is  shown 
by  this  entry  in  his  note-book  of  September  lo,  "  Thank 
God !  out  of  one  hundred  patients  whom  I  have  visited  or 
prescribed  for  this  day  I  have  lost  none." 

That  is  the  sort  of  thing  which  runs  through  his 
writings.  It  is  that  sort  of  joyous  and  enthusiastic  op- 
timism which  gives  pause  to  the  modern  observer,  with 
his  exact  methods  and  his  critical  and  sceptical  mind. 
What,  pray,  is  one  to  believe  if  Rush  could  write  such 
stuff  as  this,  which  implies,  if  it  does  not  assert,  that  he 
had  found  the  certain  cure  for  yellow  fever?  Yet  that 
was  his  genuine  belief.  The  credulity  of  those  men  was 
often  thus  manifested,  and  in  another  place  Rush  himself 
tells  us  that  "  The  pulmonaiy  consumption  .  .  .  even 
when  tending  rapidly  to  its  last  stage  has  been  cured  by 


BENJAMIN    RUSH.  171 

bleedings,  digitalis  and  mercurial  salivation,"  "  Gout  has 
been  torn  from  its  ancient  sanctuary,"  "  Dropsy  is  cured," 
"  Tetanus  is  prevented  by  inflaming  the  injured  parts, 
.  .  .  and  often  cured  by  opium,  bark,  and  wine,"  "  Mad- 
ness has  yielded  to  bleeding,  low  diet,  mercury,  etc.,"  and 
"  the  last  achievement  of  our  science  consists  in  the  dis- 
covery and  observation  of  the  premonitory  signs  of  mortal 
diseases  and  in  subduing  them  by  simple  remedies  in  their 
forming  state."  ^^ 

We  are  told  that  the  credit  acquired  by  this  method  of 
treating  yellow  fever  almost  killed  the  fortunate  inventor 
by  the  overwhelming  mass  of  practice  it  brought  him.  In 
the  first  week  after  its  publication  he  visited  and  pre- 
scribed for  between  one  hundred  and  one  hundred  and 
fifty  patients  a  day.  He  was  never  idle.  The  people  be- 
sieged him  at  his  meals  and  clamored  at  his  bedroom 
door.  He  was  obliged  to  do  much  of  his  practice  vicari- 
ously, and  his  pupils  were  kept  busy  night  and  day  com- 
pounding powders,  bleeding,  and  visiting.  It  is  not 
surprising  to  learn  that  he  broke  down  under  the  strain. 
The  nature  of  his  illness  is  not  entirely  obvious,  but  one 
is  left  to  assume  that  it  was  the  prevailing  fever.  At 
any  rate,  he  submitted  to  his  own  heroic  remedies,  sur- 
vived them,  and  lived  yet  twenty-three  years.  As  Ram- 
say says,  this  year  laid  the  foundation  for  his  enduring 
fame.  Had  he  lived  in  the  pagan  world,  he  would  have 
been  deified;  had  he  lived  in  the  Dark  Ages  of  Chris- 
tendom, he  would  have  been  canonized. 

But  he  had  made  enemies  by  his  outspeaking  and  by 
his  phenomenal  success.  Many  influential,  honest  citizens 
thought  that  he  had  hurt  their  town  by  teaching  that  the 
pestilence  was  not  imported,  but  arose  de  novo  therein; 
many  of  his  professional  brethren  hated  him  for  his 
methods  and  his  popularity.     William  Cobbett,  a  clever 


Medical  Inquiries  and  Observations,  vol.  iv.  p.  393  et  seq. 


172  MEDICINE    IN   AMERICA. 

and  unscrupulous  journalist,  was  enlisted  to  attack  Rush, 
and  his  paper,  Peter  Porcupine's  Gazette,  soon  teemed 
with  viperous  attacks  upon  the  new  treatment, — the  doc- 
trines and  their  author.  The  outcome  of  it  all  was  that 
Rush  was  induced  to  prosecute  Cobbett  in  the  courts.  He 
succeeded  in  punishing  him  in  a  fine  of  five  thousand  dol- 
lars and  in  driving  him  out  of  town.  The  unfortunate 
editor  went  to  New  York,  published  there  for  a  time  a 
paper  called  the  Rusklight,  and  then  flickered  out  and 
was  forgotten.  His  articles  are  not  edifying,  and  even 
Rush's  defence,  from  our  modern  point  of  view,  might 
better  have  been  left  unsaid. 

The  wretched  editor  was  punished,  but  the  controversy 
lived;  and  though  Rush's  great  name  and  services  bore 
down  opposition  and  long  survived  the  man,  he  could  not 
escape  the  fate  of  all  system-builders  in  science;  there 
arose  a  rival  school,  and  for  many  years,  even  until  the 
time  when  men  came  to  know  that  science  is  knowledge, 
in  which  systems  have  no  place,  his  disciples  and  their 
opponents  continued  to  discuss  the  merits  and  demerits 
of  the  American  Sydenham. 

Among  the  other  conspicuous  labors  of  this  incessant 
writer  was  his  work  as  an  alienist.  A  prominent  physician 
says,^^  "  Benjamin  Rush  and  Isaac  Ray  are  the  two 
Americans  who  have  done  most  for  Psychiatry.  .  .  .  Un- 
til the  year  1883  the  only  systematic  American  treatises 
on  insanity,  either  in  its  medical  or  medico-legal  rela- 
tions, came  from  the  pens  of  these  two  remarkable  men." 

It  is  needless  here  to  do  more  than  refer  to  Rush's 
labors  in  this  great  field.  His  studies,  lectures,  and  prac- 
tice were  thorough  and  original  therein,  and  his  apprecia- 
tion of  the  value  of  the  study  of  mental  disease  appears 
from  the  fact  that  such  instruction  of  his  was  given  to  the 
students  in  regular  course,  for  he  regarded  the  subject  as 


Charles  K.  Mills,  Benjamin  Rush  and  American  Psychiatry,  li 


BENJAMIN    RUSH.  173 

of  vital  importance  to  all  physicians.  He  was  one  of  the 
first  to  classify  mental  afflictions,  and  to  distinguish  the 
various  states  from  the  points  of  view  of  etiology  and 
prognosis.  His  treatment,  too,  was  often  rational  and  far 
in  advance  of  his  times.  Here,  as  in  all  his  lectures  on 
therapeutics,  he  insisted  upon  the  importance  of  personal 
hygiene,  especially  upon  the  value  of  proper  food,  bathing, 
fresh  air,  exercise,  and  abstinence  from  stimulants. 
Mills's  article  is  an  admirable  resume  of  his  doctrine  and 
teaching,  well  worth  the  reading  by  those  so  minded. 

So  catholic  were  Rush's  interests  and  so  eager  was  he 
in  the  imparting  of  information  that,  except  for  the  fine 
arts  and  surgery  as  distinguished  from  medicine,  few  sub- 
jects germane  to  the  life  of  an  accomplished  scholar  and 
physician  escaped  his  scrutiny. 

Of  temperance  he  was  the  constant  preacher,  far  in  ad- 
vance of  his  day.  He  estimated  that  in  the  United  States 
four  thousand  persons  died  annually  of  strong  drink,  and 
he  raised  his  voice  for  abstinence.  His  advice  to  the  in- 
temperate was  to  shun  alcohol  suddenly  and  entirely,  not 
drop  by  drop;  and  he  urged  his  brethren  to  prescribe 
tinctures  sparingly.  Unfortunately  for  the  force  of  his 
preaching,  his  hatred  of  tobacco  was  equally  strong  and 
his  condemnation  injudicious.  Of  his  antislavery  convic- 
tions we  have  already  made  some  note. 

He  wrote  vigorous,  luminous  articles  on  infectious  dis- 
eases :  malaria,  scarlatina,  diphtheria,  measles,  influenza, 
and  hydrophobia.  He  advocated  an  extensive  plan  of  free 
education,  and  published  a  useful  paper  on  the  amuse- 
ments and  punishments  proper  for  schools.  He  contrib- 
uted a  valuable  article  on  the  study  of  Greek  and  Latin  as 
a  branch  of  liberal  education,  an  address  to  clergymen  of 
all  denominations  "  upon  subjects  interesting  to  morals," 
"  Thoughts  upon  female  education,  accommodated  to  the 
present  state  of  society,"  and  "  Information  to  Europeans 
emigrating  to  this  country;"    also  a  commentary  on  the 


174  MEDICINE    IN    AMERICA. 

state  of  the  body  and  mind  in  old  age,  and  a  paper  on  the 
sugar-maple  tree.  He  edited  the  works  of  Sydenham, 
Pringle's  "  Diseases  of  the  Army,"  and  the  writings  of 
numerous  lesser  men.  While  he  lived  he  wrote  and  taught, 
and  he  practised  what  he  taught. 

His  life,  after  1793,  knew  no  striking  incidents;  the 
years  went  on,  punctuated,  indeed,  by  his  publications,  for 
he  took  no  rest  and  kept  adding  to  his  labors.  A  gray  old 
man,  alert  and  busy  as  in  youth,  he  never  put  off  the  har- 
ness, and  in  harness  he  died. 

He  died  on  April  19,  181 3,  after  an  illness  of  four  days, 
probably  of  pneumonia,  though  James  Mease,  who  at- 
tended him,  called  it  "  a  pleurisy."  At  any  rate,  the 
accounts  are  not  clear. 

Never  in  our  history  has  the  death  of  a  physician  cre- 
ated such  a  sensation.  The  man  was  one  of  the  few  sur- 
viving signers  of  the  Declaration  of  Independence  and  a 
friend  of  both  Jefferson  and  Adams.  His  contributions 
to  science  were  supposed  to  be  beyond  price,  and  his 
person  was  known  and  loved  by  thousands  of  his  fellow- 
countrymen.  It  was  said  that  since  the  death  of  Wash- 
ington no  man  was  more  universally  and  sincerely 
mourned. 

We  have  seen  of  what  sort  he  was :  a  patriot,  a  scholar, 
a  writer,  a  teacher,  and  a  physician;  yet  the  tale  is  only 
a  synopsis.  His  good  deeds  would  occupy  volumes;  but 
at  the  end  we  come  to  inquire,  On  what  does  his  fame 
rest?  Perhaps  that  question  has  already  been  answered 
in  some  fashion.  He  was  not  a  Sydenham  or  an  Hippoc- 
rates. If  one  must  find  a  comparison,  the  name  of  Boer- 
haave  suggests  itself:  the  great  student  and  furious 
worker;  convincing,  magnetic  teacher,  yet  to  the  science 
of  to-day  little  more  than  a  myth ;  forgotten  mainly  be- 
cause, with  all  his  wonderful  force  and  ability,  he  created 
nothing;  he  but  collected  and  applied  the  work  of  other 
men.     Even  this  comparison  is  in  many  respects  unfair 


BENJAMIN    RUSH.  175 

to  Rush.  He  was  all  that  we  see  in  his  Dutch  proto- 
type, but  he  originated  as  well — notably  his  theory  of 
fevers  and  his  method  of  treating  the  insane;  and,  more 
than  that,  he  led  his  generation  in  many  fields  extra- 
professional. 

But,  after  all,  it  was  not  for  these  things  that  he  was 
known  best  and  longest  remembered.  I  think,  if  we  must 
remember  him  for  any  one  thing,  it  should  be  for  the  im- 
petus that  he  gave  to  the  love  of  science  and  to  the  search 
after  truth  for  truth's  sake.  To  be  sure,  he  often  failed 
and  himself  went  wandering  after  strange  gods,  but  the 
will  was  there  and  the  sound  ideal.  We  have  seen  how 
his  pupils  went  abroad  in  the  land,  and  we  might  trace 
their  influence  for  generations.  In  his  fine  oration  on 
Cullen,  of  Edinburgh,  he  says,  "  That  physician  has  lived 
to  little  purpose  who  does  not  leave  his  profession  in  a 
more  improved  state  than  that  in  which  he  found  it.  Let 
us  remember  that  our  obligations  to  add  something  to  the 
capital  of  medical  knowledge  are  equally  binding  with 
our  obligations  to  practise  the  virtues  of  integrity  and 
humanity  in  our  intercourse  with  our  patients.  Let  no 
useful  fact,  therefore,  however  inconsiderable  it  may  ap- 
pear, be  kept  back  from  the  public  eye;  for  there  are 
mites  in  science,  as  well  as  in  charity,  and  the  remote 
consequences  of  both  are  often  alike  important  and  bene- 
ficial. Facts  are  the  morality  of  medicine;  they  are  the 
same  in  all  countries  and  throughout  all  time." 

In  large  measure  such  teaching  was  exemplified  in 
Rush's  own  life.  He  went  on  laboriously,  zealously,  fruit- 
-fully.  The  figure  still  looms  large,  though  dimmer  through 
the  years.  He  was  our  first  great  teacher,  and  for  that, 
if  for  nothing  more,  let  us  remember  him.^^ 


"  Samuel  Jackson  gives  us  the  following  summary  of  Rush's 
honors  and  publications : 

"  The  fame  of  Dr.  Rush  was  such  as  to  make  him  a  member  of 
nearly    every    medical,    literary,    and    beneficent    institution    in    his 


176  MEDICINE    IN    AMERICA. 

country;  he  was  distinguished  also  by  many  honors  from  Europe. 
He  was  a  member  of  the  Society  of  Arts  and  Sciences  of  Milan,  of 
the  Society  of  Naturae  Curiosorum,  of  the  National  Institute  of 
France,  of  the  School  of  Medicine  of  Paris ;  he  was  created  LL.D. 
by  Yale  College,  was  Treasurer  of  the  United  States  Mint  from 
1799  to  his  death,  when,  in  his  memory,  the  office  was  given  to  his 
son;  thus  it  remained  in  his  family  thirty  years,  through  the  official 
terms  of  four  Presidents. 

"  He  was  addressed  by  the  Prussian  government  on  the  subject  of 
yellow  fever,  receiving  from  the  king  a  coronation  medal,  as  a  com- 
pliment for  his  answer. 

"  He  received  the  thanks  of  the  King  of  Spain  for  his  answer  to 
queries  on  the  same  subject. 

"  He  received  a  gold  medal  from  the  Queen  of  Etruria  as  a  mark 
of  respect  for  his  medical  character  and  writings. 

"  The  Emperor  of  Russia  presented  him  on  the  same  account  with 
a  costly  diamond  ring. 

"  His  writings  are  numerous,  and  may  be  very  conveniently  set 
forth  here  in  four  departments,  showing  in  what  state  they  were 
originally  found  in  the  book-stores. 

"I. 

"  Between  the  years  1789  and  1804  he  published  five  volumes  of 
medical  inquiries  and  observations.  Of  these  he  printed  in  1805  a 
second  edition  in  four  volumes,  in  1809  a  third  edition  in  four  vol- 
umes, and  they  have  been  reprinted  since  his  death. 

"  They  comprehend  the  following  : 

"  Natural  history  of  medicine  among  the  Indians  of  North  Amer- 
ica, read  before  the  American  Philosophical  Society  in  1774. 

"  Inquiry  into  the  influence  of  physical  causes  on  the  moral  fac- 
ulty, read  to  the  Philosophical  Society,  1786. 

"  On  the  influence  of  the  American  Revolution  on  the  human 
body  and  mind. 

"  An  inquiry  into  the  relation  of  tastes  and  aliments  to  each 
other,  and  into  the  influence  of  this  relation  to  health  and  pleasure. 

"  Result  of  observations  made  on  the  diseases  of  the  military 
hospitals  during  the  Revolutionary  War. 

"  An  inquiry  into  the  effects  of  ardent  spirits  on  the  body  and 
mind. 

"  Observations  on  tetanus. 

"  On  diseases  caused  by  drinking  cold  water. 

"  On  the  cure  of  several  diseases  by  the  extraction  of  decayed 
teeth. 

"  Upon  worms  and  anthelmintic  medicines. 

"  On  arsenic  in  the  cure  of  cancer. 

"  An  inquiry  into  the  cau.se  and  cure  of  .sore  legs. 

"  Observations  on  the  duties  of  a  physician  and  on  the  methods 
of  improving  medicine. 


BENJAMIN    RUSH.  177 

"  On  the  state  of  the  mind  and  body  of  old  age. 

"  Vol.  II. — On  the  climate  of  Pennsylvania. 

"  Two  essays  on  consumption. 

"  On  the  cause  and  cure  of  dropsies. 

"  On  internal  dropsies  of  the  brain. 

"  On  the  cause  and  cure  of  gout. 

"  On  the  cause  and  cure  of  hydrophobia. 

"  On  the  cause  and  cure  of  cholera  infantum. 

"  Observations  on  cyanche  trachealis. 

"  Account  of  the  remitting  fever  of  1780. 

"An  account  of  the  scarlatina  in  1783  and  1784. 

"  On  the  measles  of  1789. 

"Account  of  the  influenza  of  1789,  1790,  1791. 

"  Vol.  III. — Outlines  of  the  phenomena  of  fever. 

"  His  various  histories  of  the  yellow  fever  in  Philadelphia  from 
1793  to  1796. 

"  Vol.  IV. — Histories  of  the  j^ellow  fever  in  Philadelphia  from 
1797  to  1805. 

"  An  account  of  the  measles  in  Philadelphia,  1801. 

"  An  account  of  the  diseases  in  Philadelphia  from  1806  to  1809 
inclusive. 

"  An  inquiry  into  the  various  sources  of  summer  and  autumnal 
diseases  in  the  United  States,  and  the  means  of  preventing  them. 

"  Facts  to  prove  yellow  fever  not  contagious. 

"  A  defence  of  bleeding. 

"  An  inquiry  into  the  comparative  state  of  medicine  in  Philadel- 
phia between  the  years  1760  and  1809. 

"II. 

"  A  volume  of  essays,  literary,  moral,  and  philosophical,  origi- 
nally published  in  the  periodicals  of  the  day;  collected  and  pub- 
lished in  one  volume,  1798,  and  frequently  republished. 

"  The  volume  consists  of : 

"  A  plan  for  establishing  public  schools  in  Pennsylvania,  and  for 
conducting  education  agreeably  to  a  republican  form  of  govern- 
ment,  1786. 

"  Of  the  mode  of  education  in  a  republic. 

"  Observations  on  the  study  of  the  ancient  languages,  with  hints 
of  a  plan  of  liberal  instruction  without  them,  accommodated  to  a 
republic. 

"  Thoughts  on  the  amusements  and  punishments  proper  in  schools. 

"  Thoughts  on  female  education,  accommodated  to  the  present 
state  of  society,  manners,  and  government  in  the  United  States. 

"  A  defence  of  the  Bible  as  a  school  book. 

"  An  address  to  ministers  of  the  Gospel  of  every  denomination 
upon  subjects  interesting  to  morals. 

"  An  inquiry  into  the  consistency  of  oaths  with  reason  and 
Christianity. 


178  MEDICINE    IN    AMERICA. 

"  An  inquiry  into  the  consistenc}^  of  the  punishment  of  murder 
by  death  with  reason  and  revelation. 

"  A  plan  of  a  peace  office  for  the  United  States. 

"  Information  to  Europeans  disposed  to  migrate  to  the  United 
States. 

"  An  account  of  the  progress  of  population,  agriculture,  manners, 
and  government  in  Pennsylvania. 

"  An  account  of  the  German  inhabitants  of  Pennsylvania. 

"  Thoughts  on  common  sense. 

"  An  account  of  the  vices  peculiar  to  the  Indians  of  North 
America. 

"  Observations  of  the  influence  of  tobacco  upon  health,  morals, 
and  property. 

"  An  account  of  the  sugar-maple  tree  of  the  United  States. 

"  The  life  and  death  of  Edward  Drinker,  aged  one  hundred  and 
three. 

"  Remarkable  circumstances  in  the  life  of  Ann  Woods,  a  woman 
of  ninety-six  years. 

"  Biographical  anecdotes  of  Benjamin  Lay. 

"  Biographical  anecdotes  of  Anthony  Benezet. 

"  Paradise  of  a  negro  slave. 

"  Eulogium  on  Dr.  Cullen. 

"  Eulogium  on  Rittenhouse. 

"III. 

"  Six  introductory  lectures  published  1801,  to  which  ten  others 
were  added  and  published,  181 1. 

"  Medical  inquiries  and  observations  on  diseases  of  the  mind,  one 
volume,  1812. 

"  The  works  of  Sydenham,  Pringle,  Cleghorn,  and  Hillary  he 
published  the  last  three  years  of  his  life,  with  original  notes. 

"  No  portion  of  his  manuscript  lectures  has  been  published  since 
his  death. 

"IV. 

"  Sermons  to  young  men  on  temperance  and  health,  1770. 

"  His  two  essays  against  negro  slavery,  1771. 

"  His  numerous  contributions  to  the  newspapers  and  magazines 
of  the  passing  time  on  literary  subjects;  during  the  war,  on  politics 
and  the  establishment  of  the  general  and  State  governments. 

"  Among  these  may  be  noted  his  four  letters  to  the  people  of 
Pennsylvania  on  the  Constitution  of  1776;  also  his  vehement  denun- 
ciation of  the  Test  Law. 

"  A  highly  interesting  and  instructive  memoir  of  Cliristopher 
Ludwik,  baker-general  to  the  Revolutionary  army,  republished  by 
the  Charity  School   Society  of  Philadelphia." 


CHAPTER    VII. 

TPIE    EIGHTEENTH    CENTURY.       ELIHU    HUBBARD    SMITH. 

A  NEW  generation,  with  new  ideas  of  medicine,  began 
to  be  known  in  those  years  following  the  Revolution.  We 
have  seen  how  the  forward  movement  of  the  time  was 
stimulating  men,  and  how  science  as  well  as  politics  was 
feeling  the  effect.  Not  that  reflective  individuals  were 
lacking  in  the  earlier  days,  but  they  had  been  pioneers; 
nor  for  many  years  was  their  influence  felt  broadcast. 
Shippen,  Morgan,  Bond,  Rush,  and  their  like  had  sown 
the  seeds.  Their  enthusiasm  had  been  quickened  and  their 
knowledge  enlarged  by  travel  and  contact  with  the  best 
minds  in  Europe;  and,  in  their  turn,  they  transmitted 
something  of  the  true  spirit  to  the  youth  at  home. 

Indeed,  in  those  years,  and  for  many  years  thereafter, 
we  were  dependent  on  Europe  for  many  things,  although 
the  seeking  of  them  out  was  the  privilege  of  the  few. 

The  new  generation  was  growing  up,  however, — a  gen- 
eration very  different  from  that  known  to  old  Zabdiel 
Boylston  and  his  froward  Douglass  in  the  beginning  of 
the  eighteenth  century.  This  was  an  era  of  men  who  had 
learned  their  lesson  from  the  stern  fathers  of  the  Revolu- 
tion, and  had  accomplished  their  humanities  in  the  grow- 
ing colleges  of  the  young  republic. 

No  man  more  than  Elihu  Hubbard  Smith  illustrates 
the  best  in  that  new  generation,  and  the  story  of  his  short 
life  is  a  pleasant  index  of  the  better  things  to  come. 

Smith  was  born  in  the  Connecticut  village  of  Litch- 
field, in  the  western  part  of  the  State,  in  the  year  1771, 
four  years  before  Bunker  Hill.  It  was  a  conspicuously 
virile  family  from  which  he  came :  five  generations  in  the 

179 


i8o  MEDICINE    IN   AMERICA. 

land,  successful  always  in  professional  life, — clergymen, 
lawyers,  and  physicians. 

In  these  days  of  city  living  we  are  apt  to  forget  the 
advantage  enjoyed  by  our  colonial  ancestors  in  the  good 
hygiene  of  an  uneventful  country  life.  There  were  no 
cities  as  we  understand  cities;  there  were  no  rich  men; 
folk  lived  strenuously,  but  within  bounds;  and  the  best 
of  them  were  still  near  the  soil.  Nor  w^as  life  so  direful 
as  in  the  early  Puritan  days.  Jonathan  Edwards  had  in- 
deed come  and  gone,  but  the  terrors  of  future  punish- 
ment for  all  but  the  elect  had  ceased  in  part,  and  with  them 
the  stern  formality  of  an  earlier  time. 

So  it  was  into  a  kindly,  well-cultivated,  simple  home 
that  young  Smith  w^as  born;  a  type  of  the  best  that  we 
have  seen  in  our  New  England  towns. 

Reuben  Smith,  his  father,  was  a  physician  widely 
known  for  his  ability  and  honest  energy;  Abigail  Hub- 
bard, his  mother,  a  daughter  of  a  well-known  Connecti- 
cut family, — well  known  before  and  since, — was  a  charm- 
ing woman  of  sense  and  education;  truly  a  mother  in 
Israel. 

It  is  pleasant  to  dwell  on  those  primitive  times  and  the 
men  they  produced ;  for,  after  all,  it  is  from  such  that 
have  come  the  best  we  have  to  show.  Those  people  are 
still  preserved  for  us  in  the  pages  of  Mrs.  Stowe;  and 
one  cannot  but  hope  that  such  honest  folk,  with  their 
earnest  inexperience,  form  to-day  the  real  basis  on  which 
we  have  to  build. 

Young  Elihu  was  a  precocious  boy,  but  not  a  prig. 
Prigs  do  not  flourish  in  such  surroundings.  He  was  one 
of  ten  children,  sons  and  daughters;  the  flower  of  the 
flock,  but  all  unknown  to  himself;  given  to  country  sports 
and  w^ork;  he  grew  up  sturdy,  modest,  sane,  brilliant,  in 
an  atmosphere  where  the  father's  work  as  physician  was 
by  no  means  the  least  salient.  Early  a  student  and  linguist, 
his  accomplishments  as  a  child  suggest  the  younger  Mill. 


ELIHU    HUBBARD    SMITH.  iSi 

When  but  eleven  years  old,  after  two  years  spent  at  the 
excellent  Greenfield  Academy,  where  he  distinguished 
himself  under  the  tuition  of  Dr.  Timothy  Dwight,  after- 
wards President  of  Yale,  he  entered  with  high  honors  the 
College  of  New  Haven,  in  the  class  of  1786. 

Even  in  those  days  eleven  was  thought  a  very  youthful 
age  for  college  boys, — though,  indeed,  the  course  at  Yale, 
as  at  Harvard  and  elsewhere,  was  little  beyond  that  of 
the  modern  High  School,  and  the  A.B.  degree  was  con- 
ferred frequently  on  lads  in  their  teens.  Still,  young 
Smith  was  a  rare  exception ;  regarded  with  pride  and  ad- 
miration by  his  teachers,  popular  and  of  good  report 
among  the  students.  He  passed  through  his  course  with 
the  highest  honors,  showing  always  an  intellectual  vigor 
and  maturity  far  in  advance  of  his  years,  and  at  the  age 
of  fifteen  was  graduated  at  the  head  of  his  class. 

He  was  graduated  at  the  head  of  his  class, — a  mere 
school-boy  we  should  account  him  in  these  days ;  yet  his 
course  was  more  than  half  run.  Some  twelve  years  re- 
mained to  him ;  years  full  of  work  and  honors. 

From  childhood  young  Smith's  career  had  been  cut  out 
for  him.  His  father's  profession  attracted  him  always 
because  it  was  his  father's,  but  his  nature  led  him  still 
more  strongly  that  way.  It  was  a  kindly  nature,  full  of 
the  new  helpfulness  of  the  day;  but,  more  than  that,  he 
was  born  with  a  love  of  knowledge  and  an  eagerness  for 
science.  More  than  other  lads,  he  would  seek  out  all 
things  for  himself,  and  even  as  a  boy  he  had  begun  to 
question  mere  authority  and  to  explain  phenomena  by 
natural  laws. 

There  was  abundant  time  at  the  outset  for  his  training 
in  medicine.  The  age  of  fifteen  seemed  far  removed  from 
serious  practice  even  then,  so  he  soberly  planned  for  him- 
self a  long  and  thorough  schooling.  For  five  years  (from 
17S6  to  1 791)  he  studied  and  practised  with  his  busy 
father  at  the  Litchfield  home — apprenticed  to  him,  as  the 


i82  AIEDICINE   IN    AMERICA. 

custom  then  \vas;  and  ^vllile  still  under  twenty  he  ac- 
quired an  intimate  practical  knowledge  of  the  country 
doctor's  life. 

The  surprising  thing  is  that,  with  all  this  grind  of  hum- 
drum routine,  he  never  lost  his  broad  professional  ideals ; 
indeed,  they  constantly  became  more  real  to  him,  and, 
far  from  sinking  into  a  mere  hack,  he  saw  always  more 
clearly  the  imperative  need  for  himself  and  his  kind  of  a 
wider  experience  and  deeper  study. 

As  we  have  seen,  those  were  days  of  small  things  in 
medicine.  The  Harvard  School  was  being  established, 
the  school  in  New  York  was  rising  again  after  the  Revo- 
lution; but  Philadelphia  was  then,  and  for  long  after- 
wards, the  ]\Iecca  for  young  Americans  seeking  the  best 
degree. 

The  year  1791  saw  the  end  of  the  controversy  between 
the  old  College  of  Philadelphia  and  the  University  of 
the  State  of  Pennsylvania.  The  two  were  united  under 
the  title  "  The  University  of  Pennsylvania,"  and  an  able, 
experienced  staff  of  teachers  was  appointed  to  the  new 
chairs:  Shippen  and  Wistar  to  Anatomy  and  Surgery; 
Kuhn  to  the  Theory  and  Practice  of  ]\Iedicine;  Rush  to 
Clinical  Medicine;  Hutchinson,  Griffitts,  and  Barton  to 
Chemistry,  Materia  Medica,  and  Botany;  veiy  strong 
names  as  we  look  back  at  them  now  after  more  than  a 
century. 

It  was  a  common  thing  in  those  days  for  young  men  of 
considerable  medical  experience  to  attend  a  medical  school 
for  one  or  two  terms  in  order  to  secure  the  degree, — in- 
deed, that  was  the  usual  course  pursued,  —  and  Smith 
accordingly  found  himself  in  contact  with  a  large  body  of 
practical  men. 

As  in  college,  so  here  again  he  was  quickly  marked  by 
his  instructors.  Rush  especially  l^ecame  his  warm  friend, 
and  an  intimacy  was  established  which  ended  only  with 
the  life  of  the  younger  man. 


ELIHU    PIUBBARD    SMITH.  183 

Smith  devoted  himself  to  the  theoretical  side  of  his 
medical  studies.  He  had  always  been  an  omnivorous 
reader,  and  now  that  he  was  living  in  an  academic  atmos- 
phere his  appetite  for  study  knew  no  bounds.  Those  were 
still  the  days  of  theories  in  the  investigation  of  diseases, 
and  he  did  not  escape  the  habit  of  his  time;  but  he  did 
appreciate  more  than  others  the  value  of  observation,  and 
his  carefully  kept  note-books  proved  to  be  a  storehouse  of 
facts  when  he  reached  the  time  for  giving  forth. 

The  disease  which  interested  him  more  than  others  w^as 
yellow  fever,  the  common  scourge  of  our  seaboard,  and 
his  formulated  opinions  later  came  to  be  held  in  very  high 
regard.  Aside  from  his  purely  professional  studies,  young 
Smith  was  by  no  means  neglectful  of  the  humanities.  He 
was  a  poet  of  some  pretension,  his  friends  thought;  he 
was  an  eager  student  of  history,  ancient  and  modern ;  he 
kept  up  his  reading  of  the  Greek  and  Latin  classics ;  and 
he  cultivated  those  men  of  like  tastes  with  himself. 
Among  others,  he  became  intimate  with  our  first  consider- 
able novelist,  Charles  Brockden  Brown,  whose  friendship 
proved  thereafter  a  warm  and  constant  one. 

Smith  spent  one  year  in  Philadelphia,  and  in  1792  was 
graduated  with  high  honor  and  the  M.D.  degree.  He  was 
not  rich,  and  practice  was  essential  to  him.  His  father 
was  growing  old  and  there  was  need  of  paying  work ;  so, 
regretfully,  he  gave  up  thoughts  of  a  city  life,  for  the 
time  at  least,  and  betook  himself  to  Wethersfield,  near 
Hartford,  in  his  native  State. 

Fortunately  or  unfortunately,  as  the  event  proved,  that 
was  for  but  a  brief  season.  The  people  of  that  country 
district  failed  to  appreciate  the  sort  of  man  that  had  come 
among  them.  He  was  but  twenty-one  years  old,  youthful 
in  appearance  and  too  eager,  perhaps,  in  his  new  mission. 
Besides,  there  was  resident  there  an  ancient  practitioner 
who  thought  little  of  the  young  man  and  his  modern 
ways. 


1 84  MEDICINE    IN   AMERICA. 

It  was  the  old  story,  then,  of  jealousy,  heartache,  and 
failure.  The  purse  was  a  short  one  and  the  road  seemed 
very  long.  For  one  year  Smith  struggled  on  the  dreary 
round;  then  the  temptation  to  a  larger  life  became  too 
much  for  him  to  resist,  no  matter  what  the  cost.  He  threw 
up  his  infant  practice,  listened  to  the  urging  of  anxious 
friends,  and  went  to  try  his  fortune  in  New  York  City. 
This  was  in  1793. 

At  the  time  of  his  going  to  New  York  the  state  of 
medicine  there  was  distinctly  chaotic.  The  physicians  of 
the  city  were  not  a  unit.  There  were  many  able  men 
among  them,  but  no  cohesion.  Jealousy  and  bickering 
had  been  doing  their  work  since  the  Revolution,  and  the 
turmoils  of  the  famous  "  Doctors'  Mob"  were  not  yet 
forgotten.  The  New  York  Hospital,  however,  was  doing 
good  work.  It  had  been  reopened  in  1791,  under  the 
auspices  of  Samuel  Bard  and  Malachi  Treat,  and  Avas  de- 
voting itself  especially  to  the  care  of  what  we  now  call 
acute  infectious  diseases. 

In  New  York  Smith  lived  five  years  and  then  died ;  and 
it  was  in  those  years  that  he  built  up  a  reputation  and 
established  a  character  which  make  him,  for  our  purposes, 
a  type  of  the  best  that  the  new  times  were  producing  in 
our  country.  Material  for  the  story  is  meagre,  but  the 
outlines  are  clearly  marked,  and  sketch  for  us  a  life  which, 
in  its  enthusiasm  for  the  truth  as  he  saw  it,  stamp  a  man 
whom  it  is  well  to  know. 

Like  old  Deacon  Fuller  also,  "  he  was  successful  in  his 
practice" — after  all,  a  fact  not  to  be  despised  when  one  is 
young  and  poor  and  ambitious.  More  than  most  men  of 
his  day,  however,  he  appreciated  the  task  which  lay  before 
immature  science,  and  he  early  conceived  the  thought  of 
a  great  development  of  national  medicine,  a  community 
of  interest  among  scientific  men.  a  working  out  of  origi- 
nal research,  and  the  interde])en(lence  of  special  brandies 
upon  one  another.    His  idea  was  a  great  American  med- 


ELIHU    HUBBARD    SMITH.  185 

ical  organization,  to  be  extended  later,  perhaps,  to  all  parts 
of  the  globe;  a  constant  interchange  of  knowledge  and 
experience;  the  upbuilding  and  perfecting  of  medical 
schools ;  the  need  of  a  broad  foundation  as  a  preliminary 
to  the  study  of  science ;  the  setting  of  a  high  standard  for 
matriculates,  and  the  winnowing  out  of  the  inefficient. 
He  appreciated  the  true  character  of  quackery  and  hum- 
bug and  the  futility  of  waging  war  with  self-convicted 
shams.  He  knew  that  our  task  must  be  to  search  out  the 
truth,  and  that  the  false  must  perish  of  its  own  decay. 

These  lofty  visions,  so  far  in  advance  of  his  time,  did 
not  lie  dormant  in  his  fertile  brain.  He  felt  at  once  that 
exposition  was  essential,  and  with  that  in  view  he  seized 
upon  the  machinery  at  hand.  There  spoke  the  practical 
genius;  no  nebulous  dreams  of  a  possible  future  con- 
tented him,  but  he  must  use  at  once  the  tools  within  his 
grasp. 

So  he  learned  the  method  which  others  had  learned  in 
older  lands,  and  established  the  first  American  medical 
periodical.  The  Nezv  York  Medical  Repository ;  and,  in 
conjunction  with  Samuel  L.  Mitchell  and  Edward  Miller, 
launched  the  ambitious  work.  All  this  may  sound  small 
to  us.  It  is  all  trite  enough  and  tame  enough,  perhaps; 
but  more  than  a  hundred  years  ago  it  marked  a  very  real 
forward  movement. 

A  French  sage  has  said  that  "  a  statesman  must  work 
as  though  he  were  to  live  forever,"  and  in  some  small  way 
this  was  the  principle  on  which  Smith  began. 

He  began  and  then  he  died,  and  the  memory  of  him  and 
of  his  work  died  with  him.  But  his  work  itself  had  caught 
the  spirit  of  the  times. 

He  was  an  exemplar,  as  it  were,  of  what  feeble  light 
then  dimly  illumined  the  minds  of  men.  Doubtless  he 
was  one  of  many,  and  they,  too,  left  the  scene;  but  the 
work  went  on,  always  stronger,  through  brilliant  modern 
years. 


i86  MEDICINE    IN   AMERICA. 

That  ambition  and  that  beginning,  ahnost  futile  they 
seem  to  us,  tell  the  man's  story.  But  there  were  other 
things  very  human  and  pathetic  needed  to  round  out  the 
eager,  youthful  life. 

One  might  have  known  that  Smith  was  a  poet. 

We  have  seen  his  eagerness  for  letters  when  a  student 
in  Philadelphia,  and  his  intimacy  with  those  of  like 
thoughts  with  himself.  He  is  supposed  to  have  been  the 
author  of  "  Andre,"  a  tragedy  in  five  acts,  performed  in 
New  York  the  year  after  his  death,  and  much  thought  of 
at  the  time.  Perhaps  his  most  ambitious  literary  produc- 
tion Avas  "  Edwin  and  Angelina ;  or,  the  Banditti."  an 
opera  in  three  acts. 

It  would  be  interesting,  were  it  not  tedious,  to  review 
this  simple  work.  Juvenile  it  is,  and  full  of  thoughts 
gleaned  from  the  older  poets;  but  it  is  still  pleasant  to 
read,  for  Goldsmith  and  men  of  lesser  note  helped  him. 

Here  are  some  liquid,  blameless  lines  which  illustrate 
his  feat : 

"I. 

"  The  mountain  streams,  full  deep  and  wide, 
By  banks  unchecked,  majestic,  slow, 
Roll  peaceful  down  the  sloping  side 

And  bless  the  ways  through  which  they  flow. 

"II. 
"  But  if  proud  man  shall  dare  restrain, 

Forests  nor  rocks  withstand  their  force. 
They  thunder  headlong  to  the  plain 
And  desolation  marks  their  course. 

"III. 
"  Yet  o'er  the  low  and  humble  dale 
Gently  their  waters  they  diffuse. 
Green  springs  the  blade,  and  through  the  vale 
Each  faded  flower  its  bloom  renews." 

That  is  a  fair  sample  of  his  rhyming ;  not  very  coherent 
and  not  very  obvious  in  intent.    The  tale  is  one  of  virtue 


ELIHU   HUBBARD    SMITH.  187 

victorious  after  many  woes;  of  bandits,  barons,  and 
beaux;  blood-thirsty  and  tuneful,  they  wander  across  the 
forest  stage.  Wronged  lovers  agonize,  tyrants  repent,  and 
virtue  in  the  disguise  of  a  monk  emerges  triumphant  from 
a  mossy  grotto. 

It  is  all  very  sweet  and  troubadour-like.  There  are 
touches  here  and  there  which  indicate  power,  the  artistic 
sense  is  not  lacking,  and  there  is  promise  of  better  things 
with  time  and  longer  life. 

Smith's  non-medical  writings  were  not  limited  to  these 
two  essays.  We  have  a  stirring  address  delivered  before 
the  New  York  Manumission  Society  in  1798,  and  an  in- 
teresting rhyming  prefix  to  the  American  edition  of  Dar- 
win's "  Botanic  Garden,"  which  he  edited. 

Doubtless  there  was  nothing  great  in  all  these,  but  they 
evinced  a  catholicity  of  interest  and  a  widely  cultivated 
mind  none  too  common  in  the  place  and  generation  in 
which  he  lived. 

During  those  years,  however,  Smith's  more  serious  in- 
terests were  actively  exhibited  in  two  directions  :  the  Med- 
ical Repository  and  the  New  York  Hospital.  The  latter 
institution  early  enlisted  his  enthusiasm,  and  in  the  year 
1796  the  governors  elected  him  one  of  the  visiting  phy- 
sicians. He  filled  the  position  with  constant  interest  and 
zeal  during  his  few  remaining  years. 

From  the  outset  of  his  hospital  work  Smith  appreciated 
the  fact,  which  has  become  a  truism  with  us,  tliat  a  hos- 
pital should  be  a  school  of  learning  as  well  as  a  refuge  for 
the  suffering.  With  this  thought  in  mind  he  surrounded 
himself  with  students  and  infected  them  straightway  with 
his  own  enthusiasm  for  work  and  for  the  study  of  disease. 
More  than  others  he  appreciated  the  value  of  observation, 
deduction,  and  exposition;  and  his  careful,  lucid  teach- 
ing made  a  profound  impression  on  the  young  men  who 
were  fortunate  enough  to  come  under  his  influence.  His 
services  to  the  hospital  and  to  the  community  were  quickly 


1 88  MEDICINE    IN   AMERICA. 

recognized,  and  his  admiring  associates  foretold  for  him 
the  highest  honors  in  their  ranks. 

The  first  strictly  medical  writing  of  his  which  has 
reached  us  is  "  Letters  to  William  Buell,  Physician,  Shef- 
field, Massachusetts,  on  the  Fever  which  Prevailed  in  New 
York  in  1795."  These  letters  were  subsequently  collected 
and  published  by  Noah  Webster.  But  his  chief  literary 
effort  was  directed  to  the  Repository.  We  have  seen  what 
his  ambitions  were,  and  the  files  of  the  journal  tell  their 
own  interesting  tale.  Indeed,  for  many  years  the  publica- 
tion proved  most  valuable  and  important.  It  lived  for 
some  sixteen  years  after  Smith's  death,  and  contains  most 
of  the  good  work  produced  in  America  by  that  genera- 
tion. 

Smith's  own  contributions  were  constant;  among  the 
most  conspicuous  were :  "  A  History  of  the  Plague  of 
Athens;"  "  Case  of  Mania  Successfully  Treated  by  Mer- 
cury;" "Observations  on  the  Origin  of  the  Pestilential 
Fever  which  Prevailed  in  the  Island  of  Grenada  in  the 
Years  1793  and  1794;"  "On  a  Singular  Disease  with 
which  Infants  are  Sometimes  Affected;"  "The  Natural 
History  of  the  Elk;"  "  On  the  Pestilential  Diseases  which 
Appeared  in  the  Ottoman,  Carthaginian  and  Roman 
Armies  in  the  Neighborhood  of  Syracuse." 

These  essays  do  not  need  review  at  this  late  date ;  suf- 
fice it  to  say  that  they  evinced  an  unusually  intelligent 
pursuit  and  appreciation  of  the  nature  of  infectious  pro- 
cesses and  marked  a  student  of  remarkable  attainments. 

It  was  earnest  investigation  of  infectious  diseases  that 
brought  the  kindly  young  life  to  an  end. 

In  those  years  no  scourge  was  more  dreaded  in  our  sea- 
ports than  the  constantly  recurring  yellow  fever.  The 
writers  of  the  day  gave  it  their  unceasing  attention,  and 
the  pages  of  the  Repository  teem  with  articles  on  the 
subject. 

It  is  needless  to  review  the  series  of  epidemics,  made 


ELIHU    HUBBARD    SMITH.  189 

familiar  by  Rush,  which  visited  our  cities  during  the 
closing  years  of  that  centuiy.  The  years  1793,  1794,  and 
1795  had  known  the  pestilence  in  its  worst  form,  and  now 
again  in  1798  there  came  another  and  still  more  grievous 
visitation.^ 

Smith  was  one  of  those  whose  studies  had  led  him  to 
the  belief  that  yellow  fever  is  not  directly  contagious. 
He  had  already  passed  through  several  epidemics  un- 
scathed, and  now  devoted  himself  during  the  summer  and 
early  autumn  unremittingly  to  the  care  of  his  stricken 
fellows.  His  attendance  at  the  hospital  was  laborious; 
and  while  thousands  fled  the  town  and  consternation 
everywhere  prevailed,  he  labored  with  his  comrades 
wherever  a  call  might  lead.  The  vivid  picture  of  those 
days  drawn  by  Mitchell,  his  associate  on  the  Repository, 
tells  the  final  story : 

"  During  the  warm  season  of  that  pestilential  year 
Elihu  H.  Smith  and  myself  had  been  associated  in  per- 
forming our  respective  duties  as  physicians  of  the  New 
York  Hospital.  We  had  frequent  conferences — we  had 
both  been  favored  with  fine  health  and  had  been  sus- 
tained in  full  enjoyment  of  our  powers,  while  the  pre- 
vailing distemper  was  destroying  lives  at  an  unusual  rate 
around  us.  We  had  more  than  once  observed  how  re- 
markably well  we  felt,  and  when  strangers  and  visitors 
called  upon  us,  how  entirely  we  were  capacitated  to  re- 
ceive them  and  enjoy  their  society. 

"  Among  these  was  the  accomplished  and  elegant 
Scandella.  In  the  difficulty  which  had  arisen  about 
procuring  a  lodging,  this  amiable  gentleman  (on  ac- 
count of  an  indisposition)  apprehended  some  serious  in- 
convenience. 

"  In  the  eagerness  of  his  friendship.  Smith  asked  him 


^  See  Packard's  History  of  Medicine  in  the  United  States,  p.  no 
et  seq. 


I90  MEDICINE    IN    AMERICA. 

to  his  own  house;  his  distress  proved  to  be  the  reigning 
epidemic. 

"  It  was  one  of  the  most  obstinate,  rapid  and  indomi- 
table cases.  It  advanced  with  such  speed  that  there  was 
time  for  but  a  few  visits. 

"  On  the  day  that  I  called  last  to  see  Scandella,  I 
found  him  overpowered  by  the  disease,  and  lying  a  corpse 
upon  the  bed.  This  was  affecting  enough ;  but  my  solici- 
tude was  exceedingly  increased  by  learning  that  Smith 
had  been  sick  since  the  preceding  afternoon.  He  was 
confined  to  his  bed  in  an  adjoining  chamber,  and  was 
wholly  ignorant  of  the  fate  of  Scandella.  On  entering 
the  room  I  roused  him  from  the  drowsy  state  in  which 
he  lay.  I  opened  the  inner  shutter  of  the  window  for 
the  purpose  of  admitting  a  little  more  light.  It  was 
early  on  Sunday  morning.  I  inquired  how  he  was  and 
received  for  an  answer,  a  frequent  one  in  those  days, 
that  he  was  not  very  unwell  and  would  be  better  by  and 
by.  I  saw,  however,  in  a  glance  enough  to  satisfy  me 
that  the  disorder  had  already  made  alarming  progress. 
But  when  he  inquired  of  me  if  it  was  not  almost  sun- 
down I  perceived  that  the  coherence  of  his  mind  was 
broken.  Miller  joined  me  in  devising  the  course  of 
treatment  for  our  invaluable  friend.  There  was  but  a 
remnant  of  time  left.  Smith  expressed  to  me  a  desire 
to  have  the  mercurial  practice  tried  upon  himself,  but 
so  implacable  and  inveterate  was  the  disease  that  the 
quicksilver  produced  no  sensible  operation  whatever  upon 
the  patient.  Black  vomiting  with  universal  yellowness 
came  on  and  he  sank  under  a  malady  which  nothing  could 
even  mitigate  or  retard.  Miller,  Johnson,  and  myself, 
with  a  very  few  others,  were  all  that  could  be  found,  on 
that  day  of  mortality,  to  follow  his  hearse. 

"  As  a  physician  his  loss  is  irreparable.  He  had  ex- 
plored, at  his  early  age,  an  extent  of  medical  learning 
for  which  the  longest  lives  are  seldom  found  sufficient. 


ELIHU   HUBBARD    SMITH. 


191 


"  The  love  of  science  and  the  impulse  of  philanthropy 
directed  his  whole  professional  career  and  left  little  room 
for  the  calculations  of  emolument.  He  formed  vast  de- 
signs of  medical  improvement  which  embraced  the  whole 
family  of  mankind." 

That  was  the  end  of  it.  The  formal,  friendly  eulogy 
tells  no  more  than  truth.  Indeed,  from  modern  vantage- 
ground,  the  estimate  seems  less  than  one  expects.  Much 
more  might  still  be  said  of  the  brilliant  career  of  this  re- 
markable young  man,  but  here  is  enough  to  illustrate  a 
type,  and  to  show  us  that  even  in  those  days  America  was 
producing  scientific  minds  of  the  highest  order,  and  to 
point  hopefully  into  the  opening  years  of  the  coming 
century. 


CHAPTER    VII  I. 

THE    EIGHTEENTH    CENTURY.       AFTER    THE    REVOLUTION. 

Before  leaving  the  group  of  men  of  whom  we  have 
been  hearing,  and  that  interesting  eighteenth  century,  we 
must  take  a  glance  at  those  two  centres  of  medicine.  New 
York  and  Boston,  and  see  in  what  fashion  they  fared 
during  the  few  years  remaining  after  the  Revolution.  Of 
Philadelphia  we  have  already  some  knowledge. 

In  New  York  medical  teaching  languished  until  1813. 
Though  there  lived  and  practised  in  the  city  a  number  of 
first-rate  men,  their  dissensions  and  jealousies  for  years 
prevented  medical  progress.  The  Hospital  made  some 
history,  however,  and  was  launched  anew  after  nine  years 
of  labor.  In  the  interval  between  1782  and  1791  the  So- 
ciety of  the  Hospital  held  annual  meetings  and  elected 
officers,  but  the  buildings  were  used  for  almost  any  pur- 
poses other  than  those  for  which  they  were  erected.  Some- 
times poor  folk  were  given  the  rooms  as  lodgings.  One 
of  the  faculty  (Bailey)  gave  some  anatomical  demonstra- 
tions there  and  did  some  operating,  and  for  a  few  months 
the  Legislature  sat  in  the  Hospital ;  but  the  most  con- 
spicuous event  connected  with  the  place  during  this  dreary 
period  was  the  once  famous  "  Doctors'  Mob."  It  was 
in  the  anatomical  era,  when  students  and  doctors  were 
making  dissections  there.  There  was  hard  feeling  and 
suspicion  about  their  finding  bodies  for  the  work, — nat- 
ural enough,  as  any  one  must  admit  who  reads  the  old 
demonstrators'  own  statements  of  their  modus  operandi 
in  procuring  material.  They  seem  to  have  rifled  graves 
whenever  they  could,  regardless  of  sex  or  condition,  and 
most  people  conceived  an  "  ignorant  prejudice"  against 
192 


XVIII.  CENTURY.   AFTER  THE  REVOLUTION. 


193 


having  their  mothers  and  sisters  dissected  by  a  parcel  of 
callow  students. 

The  "  Doctors'  Mob"  made  itself  "  famous"  on  Sun- 
day, April  13,  1788.  While  the  dissecting  was  under 
way,  a  boy  peeped  in  at  the  window,  and  some  jocular 
individual  who  spied  him  from  the  room  waved  a  dead 
arm  at  him,  so  the  boy  said.  At  any  rate,  he  was  duly 
impressed,  and  confided  his  experience  to  whomsoever 
would  hear  him,  with  the  result  that  an  angry  crowd  tried 
to  take  over  the  custody  of  the  building  and  break  up  the 
anatomical  course.  The  students  and  doctors  thought  it 
prudent  to  run  away,  and  found  sanctuary  in  the  jail, 
with  the  mob  after  them.  Then  John  Jay  came  upon  the 
scene,  exactly  how  or  why  does  not  appear;  and  peppery 
old  Baron  Steuben,  and  Mayor  James  Duane,  reading  the 
riot  act,  backed  by  a  handful  of  militia.  The  mob  pro- 
ceeded to  hustle  the  dignitaries  and  knocked  down  Baron 
Steuben,  who  lost  his  temper  and  called  out,  "  Fire, 
Duane,  fire !"  The  militia  fired,  seven  rioters  were  killed, 
many  were  wounded,  and  the  rest  went  home.  That  was 
the  famous  "  Doctor's  Mob,"  and  the  doctors  got  no 
sympathy.  The  governors  denied  their  responsibility 
for  the  doings  at  the  Hospital,  sent  in  a  bill  of  twenty- 
two  pounds  seven  shillings  tenpence  to  the  breathless 
doctors,  and,  after  collecting  the  money,  closed  up  the 
buildings. 

After  that  the  governors  seem  to  have  come  to  their 
senses,  and  really  determined  to  apply  the  Hospital  build- 
ings to  their  original  purposes.  At  any  rate,  within  three 
years  the  reform  had  been  accomplished,  and  in  January, 
1 79 1,  the  Hospital  was  again  opened.  Samuel  Bard 
helped  the  starting  and  so  did  Malachi  Treat. 

The  state  of  the  New  York  medical  schools  has  already 
been  shown,  as  they  struggled  and  bickered  through  those 
years.  Indeed,  though  the  men  were  good  men  and 
strong,  the  town  made  no  progress  as  a  medical  centre 

13 


194  MEDICINE    IN    AMERICA. 

until  the  beginning  of  that  nineteenth  century  of  which 
we  shall  have  so  much  to  hear. 

So  Philadelphia  and  New  York  went  their  ways,  and 
with  them  Baltimore  and  Charleston,  in  no  manner  re- 
markable during  the  closing  years  of  the  eighteenth  cen- 
tury. But  while  such  was  the  case  beyond  New  England, 
Boston  was  being  heard  from  once  more,  and  out  of  the 
experience  and  wrack  of  the  Revolution  there  were  ap- 
pearing there  a  set  of  men  and  measures  destined  to 
bear  an  honorable  part  in  the  history  of  our  national  medi- 
cine. 

When  the  war  ceased,  in  1782,  more  than  sixty  years 
had  elapsed  since  Mather  and  Boylston  had  said  their  say 
in  the  smallpox  matter.  Throughout  the  intervening  time 
— the  best  part  of  a  centur}^ — Boston  had  produced  no 
physician  of  great  note.  To  be  sure,  there  was  that  enter- 
prising Douglass,  a  man  ignorant  of  the  scientific  spirit, 
though  an  industrious  writer ;  then  there  had  been  various 
Clarks — five  in  successive  generations — and  James  Lloyd, 
who  was  notable  as  a  kindly  man,  well  educated  in  Lon- 
don, a  pupil  of  William  Hunter,  and,  like  the  younger 
Shippen,  a  pioneer  in  midwifery  in  this  countr}"-;  but  he 
was  not  a  teacher  or  a  writer,  and  the  dim  memor}^  and 
admirable  famih^  portraits  alone  remain  to  recall  him. 

The  local  medical  historians,  Bartlett,  Thacher,  and 
Green,  tell  a  long  and  readable  tale  of  those  eighteenth- 
century  Boston  doctors,  but  until  the  Revolutionary  days 
few  names  are  recorded  that  need  live  among  us.  With 
the  close  of  the  Revolution,  however,  there  occurred  two 
events  worthy  of  recording, — the  founding  of  the  Massa- 
chusetts Medical  Society  and  the  establishment  of  the 
Medical  Department  of  Harvard  College. — and  with  these 
events  are  linked  two  or  three  names  of  more  than  local 
interest. 

The  Massachusetts  Medical  Society  was  not  the  first 
State  or  colonial  medical  society,  but,  with  the  exception 


XVIII.  CENTURY.   AFTER  THE  REVOLUTION.   195 

of  the  New  Jersey  Society,  founded  in  1766,  it  is  the 
eldest  of  those  now  in  existence.^ 

The  more  prominent  men  among  the  original  members 
of  the  Massachusetts  Society,  whose  numbers  were  at 
first  limited  to  seventy,  were  Edward  Augustus  Holyoke, 
James  Lloyd,  Isaac  Rand,  Cotton  Tufts,  Nathaniel 
Walker  Appleton,  Aaron  Dexter,  and  John  Warren.  The 
venerable  Holyoke  is  worthy  of  recording,  if  for  nothing 
else,  because  he  lived  to  practise  medicine  at  the  age  of 
one  hundred.  That  century  of  his  marks  him  out;  but 
he  did  other  things.  He  was  born  in  Salem  in  1725,  and 
there  he  lived  his  life.  He  was  graduated  A.B.  of  Har- 
vard in  1746.  Like  so  many  of  his  time,  he  was  never 
graduated  in  medicine,  but  picked  up  what  knowledge  he 
could  from  his  preceptor,  Thomas  Berry,  and  by  his  own 
reading  and  observation.  He  practised  in  Salem  and  was 
a  good  doctor.  We  saw  how  John  Warren  went  there  in 
1774  to  grow  up  with  the  place,  hoping  to  succeed  Holy- 
oke; but  that  came  to  nothing.  He  lived  there  for  one 
year  and  then  went  into  the  army;  Holyoke  practised 
there  for  fifty-four  years  after  Warren  left.  He  was  a 
shrewd,  able  man  with  a  native  wit  and  capacity  which 
must  have  stood  him  in  the  stead  of  learning,  for  he  was 
much  respected  by  his  fellows,  and  had  attained  so  con- 
siderable a  place  among  them  that  when  the  State  Society 
was  founded,  in  1781,  he  was  made  its  first  president. 

It  has  been  shown  also  how  the  war  had  stimulated 
medicine  as  well  as  many  other  branches  of  American  en- 
deavor, and  this  Massachusetts  Medical  Society  was  a 
direct  product  of  that  stimulation.  The  State  had  fur- 
nished a  larg-e  number  of  surgeons  to  the  army,  they  had 
journeyed  through  the  land,  made  many  acquaintances, 
seen  a  great  variety  of  practice,    and    broadened   their 

^  The  facts  in  connection  with  all  the  old  societies  have  been  col- 
lected and  admirably  presented  by  F.  R.  Packard  in  his  History  of 
Medicine  in  the  United  States. 


196  MEDICINE    IN    AMERICA. 

knowledge ;  so  that  on  returning  to  the  narrower  things  of 
civil  life  they  felt  the  need  of  something  better  than  the 
old  routine  and  stagnation,  and  they  banded  themselves 
together  for  mutual  improvement.  One  may  well  imagine 
how  great  must  have  been  the  benefit  to  those  ancient  men. 
\\'e  now,  with  our  multiplied  societies  and  hospitals  and 
journals  and  books,  our  telephones  and  our  railways  and 
our  high-pressure  lives,  can  scarcely  fancy  the  isolation  of 
those  eighteenth-century  doctors  :  their  small  information, 
their  pathetic  searchings  out,  their  simplicity;  so  we  must 
believe  that  the  State  Society,  the  commonplace  of  to-day, 
was  a  very  great  and  splendid  and  life-giving  thing  one 
hundred  and  twenty  years  ago. 

The  preamble  of  the  act  of  incorporation  which  was 
signed  by  Governor  Hancock  on  November  i,  1781,  re- 
cites,— 

"  As  such  health  is  essentially  necessary  to  the  happi- 
ness of  Society;  and  as  its  preservation  or  recovery 
is  closely  connected  with  the  knowledge  of  the  animal 
economy,  and  of  the  properties  and  effects  of  medicines; 
and  as  the  benefit  of  medical  institutions  founded  on 
liberal  principles,  and  encouraged  by  the  patronage  of 
the  law,  is  universally  acknowledged :  Be  it  therefore 
enacted,"  etc. 

So  we  see  that  the  first  object  of  the  organization  was 
to  encourage  the  pursuit  of  rational  medicine.  The  act 
further  provided  for  sundry  officers,  a  seal,  the  right  to 
sue  and  be  sued,  the  election  of  members  up  to  a  total  of 
seA^enty,  and,  most  important  of  all,  authority  to  examine 
candidates  and  grant  a  certificate  of  competence  in  med- 
ical knowledge;  but  the  Society  had  no  right  to  bestow  or 
take  away  the  medical  degree. 

This  clause  in  the  charter  seemed  at  first  to  conflict  with 
the  rights  of  Harvard  College  to  bestow  medical  degrees, 
but  a  committee  of  investigation  showed  that  there  was  no 
clash  of  authority,  and  the  relation  of  the  Society  to  the 


XVIII.  CENTURY.   AFTER  THE  REVOLUTION.   197 

medical  schools  early  became  recognized,  as  it  has  con- 
tinued to  this  day.  A  school  under  its  own  proper  char- 
ter may  bestow  the  degree,  but  that  degree  gives  its 
holder  no  rights  in  the  Massachusetts  Medical  Society; 
aiid  if,  on  his  applying  for  membership  in  the  Society,  a 
candidate  is  found  unequal  to  the  rec|uired  examinations, 
he  is  refused  admission.  As  we  know,  there  is  now  no 
limit  of  membership,  but  admission  to  the  Society  has 
been  the  sine  qua  non  of  medical  respectability  in  Mas- 
sachusetts for  a  hundred  years,  and  its  ranks  embrace 
most  of  the  properly  qualified  regular  physicians  in  the 
State.  The  Censors'  examination  is  not  a  mere  for- 
mality; it  is  a  very  real  test — a  fact  so  well  known  that 
rarely  do  candidates  whose  qualifications  arc  not  up  to 
its  requirements  seek  membership.^ 

Almost  coincident  with  the  Massachusetts  Medical  So- 
ciety, the  Harvard  Medical  School  was  launched.  Like 
most  undertakings  of  the  kind,  that  was  largely  the  work 
of  one  man, — of  one  man  become  an  exponent.  The 
times  were  ripe,  and  John  Warren  seized  the  opportunity 
— another  Morgan  or  another  Bard,  as  it  were;  this  time 
found  in  Boston. 

It  is  somewhat  strange  that  Harvard  College,  so  many 
years  the  senior  of  the  New  York  and  Philadelphia  foun- 
dations, should  have  had  no  medical  department  until  it 
was  nearly  half-way  through  its  second  century  of  exist- 
ence. Various  reasons  are  assigned  for  this;  for  many 
years  it  was  little  more  than  a  theological  seminary,  and 
during  the  half-century  preceding  the  Revolution  Boston 
produced  few  doctors  of  the  academic  type,  or  of  high 
scientific  training,  or  filled  with  the  spirit  of  teaching. 

Some  feeble  reaching  out  towards  the  beginning  of  a 
medical  school  had  been  making  for  several  vears  before 


"  Dr.  S.  A.  Green  has  told  the  story  of  the  Society  in  infinite  and 
zealous  detail.  You  will  find  it  in  Medical  Communications  of  the 
Massachusetts  Medical  Society,  1881 :    A  Centennial  Address. 


198  MEDICINE    IN    AMERICA. 

the  war.  Ezekiel  Hersey,  of  Hingham,  a  graduate  of  the 
College  ill  1728,  and  a  physician  of  considerable  attain- 
ments, had  foreseen  the  need,  and  at  his  death,  in  1770, 
had  bequeathed  a  thousand  pounds  to  the  College  for  a 
chair  of  anatomy  and  surgery ;  then  his  wife  left  an  equal 
amount,  and  his  brother,  Abner  Hersey,  a  Barnstable  doc- 
tor, left  five  hundred  more  in  1787.  So  here  was  a  sum 
amounting  in  dollars  to  nearly  twelve  thousand  five  hun- 
dred. 

The  mutations  of  time  have  brought  it  about  that  Har- 
vard has  to-day  a  Hersey  Professor  of  the  Theory  and 
Practice  of  Physic,  the  Professor  of  Anatomy  being  the 
Parkman  Professor,  the  Professor  of  Surgery  being  the 
Moseley  Professor. 

Then  one  John  Cummings,  a  doctor  of  Concord,  left 
five  hundred  pounds,  in  1788,  for  a  medical  professorship; 
and  William  Ewings,  of  Boston,  an  additional  thousand. 
These  various  sums  became  available  not  long  after  the 
end  of  the  war,  the  one  grievous  regret  of  the  Medical  De- 
partment being  the  destruction  of  a  considerable  collection 
of  medical  works,  anatomical  cuts,  and  a  couple  of  skele- 
tons, which  had  been  lost  in  the  burning  of  the  College 
Library  in  1764. 

It  will  be  remembered  that  John  Warren,  the  young 
army  surgeon,  returned  to  Boston  in  1777.  There  he  had 
been  put  in  charge  of  the  Army  Hospital,  which  was 
situated  in  the  West  End,  near  where  the  Massachusetts 
General  Hospital  now  stands.  He  seems  quickly  to  have 
become  well  and  favorably  known  in  his  profession,  his 
conduct  of  the  Hospital  and  his  attainments  as  a  surgeon 
being  of  the  first  order;  and  old  American  writers  tell, 
with  some  awe,  how  he  performed  amputation  at  the 
shoulder-joint, — the  first  operation  of  the  kind  done  in 
this  country. 

It  was  in  "November,  1781,  that  the  Boston  Medical 
Association — an   organization   whose  useful   function   it 


XVIII.  CENTURY.   AFTER  THE  REVOLUTION.   199 

was  to  regulate  physicians'  fees,  for  which  purpose  it  still 
survives  timidly — voted  to  ask  Warren  to  give  a  course  of 
lectures  on  anatomy. 

That  started  the  interest.  Warren  gave  the  lectures, 
and  gave  them  admirably.  He  was  a  man  of  force,  and 
must  have  had  much  charm  of  manner.  Nearly  a  hun- 
dred years  later,  old  Jacob  Bigelow,  who  had  been  one 
of  his  students,  used  to  tell  of  the  fluency  and  eloquence 
of  Warren's  lectures  and  the  delight  of  his  hearers.  He 
knew  his  subject-matter,  too,  far  better  than  did  most  sur- 
geons of  the  day ;  for  his  army  life,  in  charge  of  military 
hospitals,  had  given  him  abundance  of  operating,  and 
he  had  been  able  to  find  material  for  his  dissections  and 
anatomical  preparations. 

Those  early  lectures  were  given  at  the  Military  Hos- 
pital and  attracted  a  distinguished  audience.  Alost  espe- 
cially President  Simeon  Willard  and  members  of  the  Col- 
lege corporation  were  impressed,  and  were  fired  with  the 
idea  that  here  was  a  promising  young  man  to  put  at  the 
head  of  a  medical  school. 

The  war  was  now  practically  over ;  men  were  returning 
to  the  ways  of  peace,  and  Harvard  proceeded  to  inaugu- 
rate the  new  era  with  this  wise  expansion.  It  was  all  hum- 
ble and  simple  enough  at  first.  The  corporation  and  War- 
ren got  together,  worked  out  the  plan  of  a  school,  and  in 
November,  1782,  rules  of  procedure  were  adopted  and 
Warren  was  elected  Professor  of  Anatomy  and  Surgery. 
The  next  month  Benjamin  Waterhouse  was  made  Profes- 
sor of  the  Theory  and  Practice  of  Physic,  and  in  the  May 
following  Aaron  Dexter  became  Professor  of  Chemistry 
and  Materia  Medica. 

These  three  men  were  for  several  years  the  only  instruc- 
tors in  the  School.  The  lectures  were  given  at  the  College 
in  Cambridge,  a  tedious  journey  from  Boston  in  those 
days,  and  it  was  not  until  1810  that  the  School  was  re- 
moved to  Boston,  where  it  rapidly  increased  in  size  and 


200  MEDICINE   IN   AMERICA. 

influence.  At  the  first  some  twent}'  medical  students, 
together  with  the  Harvard  Seniors,  attended  the  lectures, 
and  the  first  class  was  graduated  in  1785,  with  the  Bache- 
lor of  Medicine  degree. 

Of  John  \Varren,  for  very  many  years  the  most  con- 
spicuous surgeon  in  New  England  and  a  power  for  good 
in  his  community,  some  further  word  is  needed.  He  was 
a  man  of  somewhat  delicate  physique, — thought  to  have 
consumption  in  his  youth, — and  through  life  the  victim 
of  numerous  ailments;  but,  like  all  the  other  successful 
physicians  known  to  us,  he  was  an  incessant  worker. 
Lacking  the  advantage  of  a  European  education,  he  pro- 
ceeded early  to  make  up  for  it,  and  throughout  his  life 
was  a  severe  student.  Acquaintance  with  the  French  med- 
ical officers  of  the  Revolution  impressed  him  with  the  need 
of  acquiring  their  language;  so  in  the  midst  of  his  other 
duties  he  studied  French,  followed  the  French  practice, 
and  bought  their  books,  all  of  which  stood  him  in  good 
stead  when  he  came  to  teaching;  and  he  made  Sabatier 
his  text-book. 

We  know  how  his  lectures  impressed  the  dons  in  his 
early  days,  and  his  eloquence  increased  with  his  years. 
He  talked  without  notes,  to  be  sure,  but  he  told  things 
that  interested  his  hearers, — a  rare  gift, — and  he  told 
them  well.  Like  his  friend  Rush,  he  had  a  good  voice  and 
had  learned  to  use  it;  indeed,  he  neglected  none  of  those 
qualities  which  it  is  good  to  cultivate.  He  was  interested 
in  many  things,  too,  like  Rush,  and  took  his  part  in  the 
public  questions  of  the  day.  He  was  not  an  author  of 
many  works,  and  little  that  he  wrote  has  come  down  to 
us ;  but  he  was  master  of  a  simple,  forceful  style,  and  his 
few  public  addresses  are  still  pleasant  in  the  reading. 

Like  all  surgeons  of  the  day,  Warren  was  a  general 
practitioner,  and  to  him,  as  to  others  in  that  century,  it 
came  to  treat  the  yellow  fever.  He  seems  to  have  under- 
taken the  work  with  fervor,  and  to  have  been  one  of  the 


XVIII.  CENTURY.   AFTER  THE  REVOLUTION.  201 

first  to  convince  liimself  that  the  disease  was  not  con- 
tagious. Indeed,  his  work  in  investigating  its  causation 
and  pathological  anatomy  was  more  than  excellent,  though 
mostly  futile,  as  so  much  of  that  old  work  must  needs 
have  been. 

John  Warren  did  not  live  to  a  great  age.  He  died  in 
181 5,  sixty-two  years  old,  and  a  son  took  up  his  tasks. 

It  seems  to  have  been  a  fine,  honorable  career.  You 
will  find  nothing  but  praise  of  him  anywhere  written.  He 
made  no  enemies  and  did  work  worth  remembering, — two 
things  that  are  true  of  few  of  us  in  this  busy  world. 

Benjamin  Waterhouse  has  been  satirized  by  Holmes, — 
rather  unjustly,  it  is  said.  He  was  a  well-educated  man, 
having  spent  some  years  in  Europe  among  the  other  pleas- 
ures of  his  youth.  Whether  or  not  he  was  a  pompous 
drone,  who  shall  say  at  this  late  day  ?  At  any  rate,  he  was 
a  professor  for  many  long  years.  Whatever  else  he  did, 
or  was,  we  must  respect  him  for  this,  that  he  early  seized 
upon  the  teachings  of  Jenner,  and  first  among  American 
physicians  introduced  vaccination  to  his  countrymen  in 
1800.  For  this  we  may  recall  him,  perhaps,  if  memory 
serves  in  hearing  of  so  many. 

What  Aaron  Dexter  taught  of  chemistry  we  know  not. 
The  memory  of  the  good  man  is  rescued  from  oblivion  by 
Holmes,  who  recounts  a  drearily  familiar  anecdote  of  one 
of  his  experiments;  and  truly,  for  us,  that  is  the  end  of 
him. 

That  is  not  a  very  brilliant  showing  for  the  founding  of 
the  Harvard  Medical  School,  out  of  which  we  fondly  hope 
so  much  has  come.  Warren  was  the  one  star, — a  good, 
strong,  steady,  glowing  luminary.  But  the  School  got 
well  on  its  feet  without  undue  travail,'  and,  struggling 
from  small  beginnings  to  better  things,  produced  in  1790 
one  graduate,  Nathan  Smith,  of  whom  there  is  much  good 
to  tell  later. 

So  the  eighteenth  century  ended,  and  as  we  look  back 


202  MEDICINE    IN   AMERICA. 

on  it  now,  before  going  to  other  things  and  another  fash- 
ion of  men,  we  see  that  the  world  has  moved  somewhat 
since  one  hundred  years  before.  Certain  names  have  been 
given,  —  Boylston,  Morgan,  Shippen,  Bard,  Rush,  and 
Warren ;  something  to  forward  science  had  been  done  in 
Philadelphia,  New  York,  and  Boston;  some  few  books 
had  been  written,  some  few  good  thoughts  expressed ;  and 
though  the  century  may  seem  flat  and  unprofitable,  we 
must  remember  the  times  in  which  men  lived  and  the 
agonizings  which  the  infant  land  must  needs  endure 
through  many  struggling  years. 


CHAPTER   IX. 

THE    NINETEENTH    CENTURY.       EARLY    SURGEONS. 

In  the  Centennial  year  of  1876  there  was  published  in 
Philadelphia  a  little  work  of  some  three  hundred  and  sixty 
pages,  entitled  "  A  Century  of  American  Medicine."  It 
may  still  be  read  with  interest  and  wonder  and  some  de- 
gree of  regret.  Five  men  wrote  the  essays  which  compose 
it.  Three  of  them  are  dead.  The  first  four  articles  are 
by  distinguished  clinical  teachers,  the  fifth  is  by  the  ablest 
of  our  medical  bibliographers. 

The  four  clinical  writers  tell  in  kaleidoscopic  detail  the 
names  and  deeds  of  American  doctors.  It  is  a  dictionary 
rather  than  a  history  that  one  reads ;  but  the  names  and 
the  deeds  are  all  so  good  that  one  struggles  painfully  and 
vainly  to  select  the  best.  It  is  evident  that  those  writers 
were  full  of  the  national  spirit  of  accomplishment,  that 
they  strove  with  great  measure  of  success  to  tell  us  the 
things  done  and  the  names  of  the  doers,  little  regarding 
those  things  of  more  vital  interest, — the  spirit  of  their 
heroes  and  of  their  times,  the  sort  of  men  those  heroes 
were,  the  sort  of  lives  they  led,  their  influence  upon  the 
people,  their  value  to  posterity.  Listen  to  the  summing 
up  of  the  essay  on  surgery.  It  was  written  by  Samuel  D. 
Gross : 

"  Finally,  let  it  not  be  supposed  from  what  precedes  that 
the  American  surgeon  is  a  mere  operator;  if  he  ranks 
high  in  this  particular,  he  ranks  high  also  as  a  therapeutist. 
Nowhere,  it  may  be  safely  asserted,  are  the  great  prin- 
ciples of  surgery  better  taught,  or  better  understood,  than 
they  are  in  this  country.  As  a  general  practitioner,  skilled 
in  diagnosis,  and  in  the  art  of  prescribing,  it  is  no  pre- 
sumption to  affirm  that  he  has  no  superior.    If,  as  a  body, 

203 


204  MEDICINE    IN    AMERICA. 

we  are  deficient  in  any  particular,  it  is  in  the  more  refined 
and  subtile  portions  of  our  studies;  studies  which,  after 
all,  are  of  no  essential  practical  importance,  and  which,  it 
is  not  too  much  to  say,  will  in  due  time  receive  their  just 
proportions." 

Then,  going  on  to  tell  of  American  success  in  the  treat- 
ment of  wounds  as  an  example  of  our  forwardness  and 
excellence,  he  said,  "  Little,  if  any,  faith  is  placed  by  any 
enlightened  or  experienced  surgeon  on  this  side  of  the 
Atlantic  in  the  so-called  carbolic  acid  treatment  of  Pro- 
fessor Lister.''  It  was  all  a  delightful  eulogy  of  American 
men  and  home  methods,  a  psean  of  joy  that  we  were  what 
we  were,  and  written  in  the  very  3"ear  of  Lister's  visit  to 
Philadelphia  and  the  famous  demonstration  of  his  stu- 
pendous discover}-.  jMedicine  and  surgery  were  on  the 
eve  of  the  greatest  revolution  known  to  our  science,  and 
the  prophet  was  in  our  midst,  but  he  was  without  honor. 

J.  S.  Billings,  the  fifth  writer,  the  kindly  but  severe 
critic,  said, — 

"  We  have  had,  and  still  have,  a  very  few  men  who 
love  science  for  its  own  sake,  whose  chief  pleasure  is  in 
original  investigations,  and  to  whom  the  practise  of  their 
profession  is  mainly,  or  only,  of  interest  as  furnishing 
material  for  observation  and  comparison.  ...  Of  the 
highest  grade  of  this  class  we  have  thus  far  produced  no 
specimens :  the  John  Hunter,  or  Virchow.  of  the  United 
States  has  not  yet  given  any  sign  of  existence." 

Between  these  two  estimates  of  the  \ah\e  of  American 
accomplishments  and  the  worth  of  American  aims  let  each 
man  choose.  The  words  were  written  more  than  a  quar- 
ter of  a  centur}'^  ago.  and  we  are  hopeful  that  time  has 
modified  both  views.  But  it  is  with  an  earlier  period  that 
this  history  deals;  not  with  the  immediate  past  and  its 
bck  of  perspective,  of  which  the  writers  told  in  that  Cen- 
tennial book. 

Let  us  then  attempt  to  see  clenrly  the  better  men  of  the 


XIX.  CENTURY.     EARLY    SURGEONS.      205 

first  half  of  the  nineteenth  century,  and,  from  the  stories 
of  a  few  conspicuous  Hves  which  reached  out  and  touched 
and  intermingled,  try  to  build  up  a  picture  of  the  medicine 
of  those  times. 

We  have  learned  what  the  influence  of  Europe  was 
upon  the  practice  and  teaching  of  the  pre-Revolutionary 
days,  especially  the  influence  of  Edinburgh  and  London, 
and  how,  after  the  war,  there  began  to  appear  among  us 
men  who  were  of  a  new  type, — a  true  American  type; 
men  who,  without  foreign  training,  began  to  see  things 
and  make  incjuiries  for  themselves;  men  of  the  type  of 
Smith  in  medicine  and  Warren  in  surgery — purely  Ameri- 
can products.  These  and  others  continued  to  appear  and 
grow  and  multiply  in  our  country  as  time  went  on : 
coming  in  groups  in  the  medical  centres, — Philadelphia, 
New  York,  Boston,  Baltimore,  Charleston,  and  New  Or- 
leans ;  then  spasmodically  in  the  wilds, — Kentucky,  Ohio, 
and  elsewhere, — showing  a  steady  growth,  long  unappre- 
ciated. For  many  years,  of  course,  the  influence  of  one 
or  other  Old- World  centre  was  felt  to  a  greater  or  less 
extent :  first  it  was  the  English  and  Scotch  schools,  then 
those  of  Paris,  then  of  Vienna;  but  as  time  w^ent  on,  as 
knowledge  spread  and  the  European  schools  came  nearer 
together,  we  began  to  hear  less  of  tl^  French  influence 
or  the  German  influence ;  to  appreciate  that  science  knows 
no  geography,  and  that  all  faithful  students  are  inter- 
dependent and  must  advance  together.  That  last  ideal 
state,  however,  has  but  recently  begun  to  develop  itself. 
In  the  early  days  there  were  found  in  Europe  very  emi- 
nent men  and  groups  of  men  to  whom  we  looked,  and 
they  doubtless  did  in  great  measure  mould  us,  so  far  as 
foreign  minds  may  mould. 

There  was,  first  of  all,  and  pre-eminently  first,  that 
famous  John  Hunter  of  whom  we  have  heard,  whose  in- 
fluence has  grown  and  spread  to  this  very  day.  Slowly 
he  was  becoming  known  to  xA.mericans  one  hundred  years 


2o6  MEDICINE    IN    AMERICA. 

ago  and  was  helping  to  shape  their  thoughts.  Of  him 
and  of  those  others  in  his  century  a  brief  word  has  been 
said.  That  Enghsh  influence  continued,  becoming  less 
potent  as  time  went  on  and  other  schools  were  sought, 
dividing  our  admiration.  Then  there  came  a  time  in  the 
first  half  of  the  nineteenth  century  when  Paris  ruled  su- 
preme, and  that  era  of  French  influence  lasted  some  forty 
years.  Indeed,  as  Osier  has  said,  "  The  awakening  came 
in  France."  ^  It  was  Bichat  who  voiced  it  to  the  think- 
ing world, — a  wonderful  young  man.  He  was  born  in 
1 77 1  and  died  in  1802.  The  year  before  he  died  he  pub- 
lished his  great  work  on  general  anatomy.  In  that  he 
turned  fiercely  away  from  all  those  system-makers  of  his 
time  and  showed  that  the  true  seat  of  disease  is  not  in 
organs  or  in  fluids  or  in  this  or  in  that  metaphysical  thing, 
but  in  the  tissues  of  which  the  organs  are  composed.  Then 
he  died ;  but  his  work  had  taken  root,  his  words  fell  upon 
soil  already  tilled  by  Morgagni,  by  Haller,  and  by  Hunter, 
and  his  views  gave  a  lasting  impetus  to  the  study  and 
understanding  of  pathological  changes. 

Then  there  were  Corvisart,  Dupuytren,  and  Laennec, 
the  proper  founders  of  the  Anatomical  School  of  Paris; 
Montpellier,  who  wrote  the  famous  Pathological  Anat- 
omy on  which  he  worked  for  thirty- four  years;  Andral, 
the  indefatigable  clinician  and  teacher;  and  Louis,  be- 
loved of  American  students, — the  man  of  them  all  best 
known  among  us  to-day,  the  patient  exponent  of  the  nu- 
merical method,  the  sympathetic  friend  and  patron  of  our 
younger  Jackson.  Those  are  a  very  few  of  the  names 
which  were  household  words  in  the  ears  of  our  fathers. 

If,  eighty  years  ago,  one  had  asked  the  name  of  the 
best-known  and  the  greatest  living  American  surgeon,  the 
reply  would  surely  have  been.  Dr.  Physick. 

Philip  Syng  Physick  was  born  in  Philadelphia  on  July 


'The  Progress  of  the  Century  (Medicine),  p.  175. 


XIX.  CENTURY.     EARLY    SURGEONS.      207 

7,  1768,  and  died  there  on  December  15,  1837.  He  was 
a  distinguished  personage,  he  hved  in  modern  times,  he 
walked  in  the  sight  of  men  all  his  days,  he  was  much 
written  about,  and  he  left  behind  him  the  report  of  many 
things  accomplished;  yet  it  is  hard  to  learn  much  about 
him, — about  the  man  himself, — and  what  one  does  learn  is 
not  thrilling. 

To  our  twentieth-century  thinking,  Physick  was  the 
best-equipped  surgeon  of  his  generation.  His  father  was 
a  respectable  Englishman,  Edmund  Physick,  who  held  a 
small  government  appointment  in  Philadelphia  in  his  early 
life,  and  after  the  Revolution  became  the  agent  there  of 
the  Penn  family.  His  mother  was  the  daughter  of  one 
Syng,  a  silversmith,  and  is  said  to  have  been  a  woman 
of  much  force  of  character.  This  commonplace  couple 
seem  to  have  held  correct  ideas  of  the  value  of  thorough- 
ness in  education,  and  having  from  his  childhood  destined 
their  son  to  be  a  doctor,  they  proceeded  to  give  him  the 
best  possible  preparation.  Whether  or  not  his  own  sur- 
prising surname  put  the  idea  of  this  profession  into  Ed- 
mund Physick's  head,  no  man  may  say,  but,  like  a  true 
Englishman,  he  clung  to  the  plan  even  against  his  son's 
earnest  protest. 

So  the  father  began  patiently  at  the  bottom.  He  was 
well  to  do  and  could  pay  for  what  he  wanted.  Robert 
Prout,  the  local  historian  and  principal  of  a  Friends'  acad- 
emy, was  induced  by  double  fees  to  take  young  Physick 
into  his  family  and  to  act  as  his  tutor. 

From  the  decorous  and  even  tenor  of  Physick's  adult 
life  we  are  led  to  suppose  that  his  well-balanced  youth 
was  equally  uneventful.  At  any  rate,  no  details  thereof 
seem  to  have  been  deemed  worth  recording.  He  was  a 
methodical  person  from  first  to  last.  From  school  the 
young  man  went  to  the  University  of  the  State  of  Penn- 
sylvania, whence  he  was  graduated  Bachelor  of  Arts  in 
1785,  at  the  age  of  seventeen.     Thus  it  will  be  seen  that 


2o8  MEDICINE    IN    AMERICA. 

all  his  preparatory  years  were  lived  during  the  exciting 
times  of  the  Revolution,  and  that  when  he  came  to  take 
up  his  medical  studies  he  found  himself  under  the  in- 
fluences of  men  who  had  borne  their  part  in  that  trying 
ordeal.  Morgan  died  soon  afterwards,  but  Shippen^ 
Rush,  and  Kuhn  continued  their  ministrations  for  many 
years  longer. 

Physick  objected  to  studying  medicine.  He  said  that 
he  had  no  taste  for  the  work  or  the  life,  and  his  first  sight 
of  dissection  at  the  Medical  School  and  operations  at  the 
Hospital  so  disgusted  him  that  he  begged  his  father  to  let 
him  off;  but  that  sturdy  person  would  not  listen  to  the 
plea,  so  the  lad  yielded  to  the  inevitable  and  the  work 
went  on.  He  was  a  student  in  Adam  Kuhn's  office  for 
three  years.  The  preceptor  was  at  that  time  Professor  of 
Chemistry  in  the  College  of  Philadelphia,  though  later 
he  went  over  to  the  University  School, — this  was  before 
their  union, — and  Physick  attended  lectures  at  the  College 
with  the  other  lads.  He  was  a  faithful,  scrupulous,  toil- 
ing soul;  something  of  a  prig,  I  fear,  and  not  popular 
with  his  mates.  He  does  not  seem  to  have  worked  with 
any  special  interest  or  intelligent  view-point  in  those  early 
days,  but  devoured  readily  whatever  mental  pabulum  was 
offered  him.  When  he  was  advised  to  study  Cullen's 
"  First  Lines  of  the  Practice  of  Physic,"  he  learned  by 
heart  the  whole  of  the  dreary  stuff,  and  he  showed,  as  yet, 
not  the  slightest  disposition  to  become  a  surgeon.  It  was 
a  sound,  painstaking  intelligence,  however,  able  and  will- 
ing, and  his  friends  foretold  good  things  for  him. 

He  probably  picked  up  all  that  there  was  to  learn  from 
the  undigested,  rudimentary  system  of  teaching  of  his 
day  and  the  practice  of  the  excellent  Kuhn,  and  in  1789, 
when  he  was  twenty-one,  his  father  took  him  to  London 
for  further  polish.  There  he  fell  on  his  feet  and  was  made 
a  man  of,  surgically.  He  had  the  rare  good  fortune  to 
be  taken  into  the  family  of  John  Hunter  and  to  win  the 


XTX.  CENTURY.     EARLY    SURGEONS.      209 

regard  of  that  great  man.  Anything  more  incongrnous 
than  an  intimacy  between  the  rough  and  tough  old  Scotch- 
man and  the  precise,  methodical,  prim  Philadelphian  it  is 
hard  to  imagine,  but  it  is  said  that  such  an  intimacy  did 
spring  up.  They  were  both  tireless  students,  devoted  to 
science  in  their  several  ways.  Hunter,  with  his  wide- 
grasping  mind  and  enthusiasm  for  facts,  snorted  con- 
tempt at  the  average  commonplace  men  about  him;  and 
Physick,  patiently  bound  up  with  the  thing  in  hand,  had 
thought  for  nothing  else.  So  the  two  men  worked  com- 
fortably together,  and  the  rare  dissecting  skill  of  the  pupil 
won  the  admiration  of  the  master.  Then  Hunter  had  him 
made  House  Surgeon  at  St.  George's  Hospital.  So  far  as 
I  know,  he  was  the  first  American  to  hold  a  position  on  the 
House  Staff  of  a  London  hospital. 

What  man  with  brains  in  his  head  and  hands  to  work 
withal  could  fail  to  succeed  after  two  years  of  John 
Hunter  and  St.  George's  ?  It  is  told  of  him  that  while  in 
residence  at  the  Hospital  he  reduced  a  dislocated  shoulder, 
"  without  the  aid  of  an  assistant  or  of  apparatus  of  any 
kind,"  before  the  class.  Just  what  that  means  does  not 
appear,  but  we  know  that  there  were  clever  mechanics 
before  the  days  of  Kocher. 

In  all  ways  Physick  seems  to  have  behaved  himself  well 
at  the  Hospital,  to  judge  from  the  testimonials  to  his 
"  medical  qualifications  and  correct  deportment"  given 
him  by  the  authorities.  Besides,  Hunter  wanted  him  for 
a  partner,  and  it  is  hard  to  see  why  he  did  not  accept 
the  offer.  Perhaps  Hunter  did  not  make  it  attractive 
enough.  If  he  had  stayed  in  London,  Physick  would  have 
been  the  colleague  of  Astley  Cooper,  Abernethy,  Carlisle, 
Home,  and  such  others,  as  John  Bell  points  out;  cer- 
tainly an  enviable  position  for  a  friendless  young  Ameri- 
can. But  his  carefully  laid  plans  could  not  be  changed; 
so,  with  kindly  words  from  his  warm-hearted  chief,  he 
went  on  his  way, — this  time  to  Edinburgh  for  a  year's 

14 


2IO  MEDICINE    IN    AMERICA. 

study  of  medicine  and  the  doctor's  degree.  That  was  in 
1 79 1.  Before  leaving  London  he  received  the  hcense  of 
the  Royal  College  of  Surgeons,  and  the  Edinburgh  M.D. 
followed  in  1792.     He  was  then  twenty- four  years  old. 

That  was  a  remarkable  preparation  for  the  practice  of 
medicine  in  the  America  of  the  eighteenth  century.  In- 
cluding his  college  course,  he  had  spent  eleven  years  in 
study.  Morgan  is  the  only  other  American  of  the  time 
who  did  as  much,  so  far  as  I  have  learned ;  but  there  was 
genius  in  Morgan. 

So  Physick  came  home  and  settled  down  "  to  look  for 
business,"  as  the  phrase  then  was.  Three  years  passed 
before  he  began  to  find  it,  and  three  years  was  a  long  time 
in  those  days.  We  know  how  Cadwalader,  Barton,  Ship- 
pen,  Morgan,  and  Rush  stepped  almost  at  once  into  a 
living  wage;  but  Physick  had  few  of  those  outward 
graces  that  attract. 

Let  us,  then,  look  briefly  at  the  young  man  starting 
under  such  auspices,  who,  beginning  a  professional  life 
which  was  to  last  through  forty-five  years,  was  to  leave 
behind  him  a  reputation  for  surgical  skill  of  the  first  order, 
and  with  the  high-sounding  title,  "  Father  of  American 
Surgery." 

Like  many  other  eminent  American  doctors  of  his  day, 
Physick  was  weak  physically.  We  have  seen  Rush  and 
Warren  fighting  a  feeble  constitution  all  their  lives  and 
Morgan  worn  out  in  his  prime.  Physick  had  a  wretched 
digestion  always,  and  was  the  victim  of  a  continually  re- 
curring "  catarrh,"  whatever  that  may  mean.  Like  many 
dyspeptics,  he  was  pessimistic,  reserved,  and  forbidding; 
shy,  one  would  suppose  from  what  is  told  of  him,  and 
devoid  of  every  vestige  of  the  sense  of  humor.  He  was 
of  medium  height,  with  pale,  regular,  classic  features — 
what  women  call  "  interesting  looking."  He  was  very 
human,  however,  in  his  attitude  towards  genuine  suf- 
fering;  but,  more  than  most  surgeons,  he  was  intolerant 


XIX.  CENTURY.     EARLY    SURGEONS.      211 

of  hysterics,  prolixity,  and  humbug  in  his  patients.  One 
of  the  historians  tehs  us  that  from  his  youth  his  want 
of  imagination  held  him  back  from  an  open  declaration 
and  acceptance  of  revealed  religion,  and  that  his  sad  and 
abstracted  manner  was  due  to  his  doubts  and  inability  to 
accept  the  true  faith.  Probably  the  real  explanation  w^as 
a  chronic  dyspepsia.  In  his  daily  routine  he  was  a  man 
of  good  sense,  and  his  habitual  reticence  stood  him  in  the 
stead  of  tact.  He  had  small,  delicate,  nervous,  facile 
hands.  It  was  a  pleasure  to  see  him  operate.  He  could 
not  dance,  though ;  he  was  heavy-footed ;  the  biographer 
leaves  us  in  no  doubt  about  that.  "  Formally  polite"  he 
calls  him,  which  sounds  well  enough. 

Probably  Physick  contributed  to  his  own  prolonged  ill 
health  by  his  obstinate  dislike  of  the  rules  of  proper 
hygiene.  He  starved  his  body  by  small  and  infrequent 
meals,  which  was  as  well,  perhaps;  but  he  hated  fresh 
air,  cold  water,  sun,  and  exercise.  When  he  felt  ill,  he 
shut  himself  up  in  a  superheated  room,  and  he  slept  in 
winter  in  a  bedroom  hermetically  sealed  and  at  a  tempera- 
ture of  80°  F. 

For  all  that,  he  accomplished  a  great  deal  in  the  way 
of  work.  Indeed,  he  worked  as  hard  as  do  most  success- 
ful surgeons.  He  kept  no  such  hours  as  did  Astley  Cooper, 
whose  vigorous  frame  seemed  to  defy  the  demands  of 
nature  for  sleep  and  food,  but  he  labored  all  of  his  waking 
life.  He  rose  at  four  in  the  morning,  wrote,  breakfasted, 
paid  visits,  lectured,  dined,  received  patients,  visited  some 
more,  supped,  and  went  to  bed  at  nine  o'clock.  He  would 
not  allow  himself  to  be  called  at  night.  That  sounds  like 
a  fairly  strenuous  life. 

He  cared  nothing  for  literature,  for  art,  for  politics, 
or  for  the  thousand  things  that  interest  men.  Nature  was 
a  sealed  book  to  him ;  he  regarded  her  only  as  she  supplied 
drugs  and  food.  After  his  student  days  he  read  little  or 
nothing,  even  of  medicine.    He  knew  his  own  ability  and 


212  MEDICINE    IN    AMERICA. 

found  himself  a  leader  of  surgeons,  so  he  cared  nothing 
for  the  observations  and  pursuits  of  other  men.  Those 
were  the  days  of  some  very  great  ones  in  his  profession, 
both  at  home  and  abroad.  Valentine  Mott  in  New  York, 
McDowell  and  Dudley  in  Kentucky,  and  John  C.  Warren 
in  Boston — to  say  nothing  of  some  excellent  surgeons  in 
Europe — were  doing  things  worth  knowing  and  remem- 
bering; but,  though  Physick  knew  personally  most  of 
these  people,  he  never  kept  in  close  touch  with  them,  and 
lived  a  life  sufficient  unto  himself.  He  was,  however,  too 
conspicuous  a  man  and  too  good  a  surgeon  to  escape  their 
interest,  and  he  influenced  them  and  others.  Towards 
the  end  of  his  life  Physick's  aloofness  and  other  pecu- 
liarities grew  upon  him.  He  became  a  very  lonely  old 
man,  retired  and  somewhat  abnormal,  perhaps,  at  the  end ; 
and  the  instinct  of  the  surgeon  and  anatomist  forsook  him 
so  far  that  he  left  positive  orders  that  no  post-mortem 
examination  of  his  body  should  be  made,  that  the  corpse 
should  be  presei*ved  until  decomposition  had  set  in,  that 
he  should  be  buried  in  a  double  coffin,  and  that  his  grave 
should  be  guarded  for  six  weeks  after  his  burial. 

Physick  was  a  penurious  man,  but  no  extortionist.  In- 
deed, his  fees,  even  at  the  height  of  his  fame,  were  so 
much  smaller  than  those  of  his  professional  brethren  as  to 
excite  reproach.  He  inherited  money,  lived  simply,  and 
left  behind  him  a  large  fortune.  In  many  cases  he  refused 
to  take  any  fee;  the  most  notorious  example  of  this  being 
in  the  case  of  John  Marshall,  the  great  Chief-Justice. 
Any  one  among  us  to-day  who  has  heard  of  Physick 
probably  connects  him  with  Philadelphia  and  Chief- 
Justice  Marsliall's  thousand  stones  in  the  bladder.  We 
nil  know  that,  if  wc  know  nothing  else  about  him.  That 
1ic  refused  a  fee  in  the  case  is  not  uninteresting. 

Now,  Physick  had  his  Fidus  Achates  —  his  nephew, 
John  Syng  Dorsey,  who  died  in  1818,  only  thirty-four 
years  old.     Dorsey  seems  to  hnve  been  many  tilings  that 


XIX.  CENTURY.    EARLY    SURGEONS.      213 

Physick  was  not :  buoyant,  sanguine,  enthusiastic,  popu- 
lar, vigorous,  and  devoted  to  his  more  famous  uncle.  He 
wrote  a  book  on  surgery  which  was  good  and  widely  cir- 
culated ;  it  was  a  compendium  of  Physick's  teaching,  and 
preserves  for  us  our  only  satisfactory  knowledge  of  the 
latter' s  opinions  and  method.  The  younger  man  was 
deeply  mourned,  and  his  death  was  a  cruel  blow  to  the  soli- 
tary, pathetic  uncle. 

When  we  come  to  follow  the  life  of  the  "  Father  of 
American  Surgery"  we  find  very  few  events  to  record,  and 
there  is  in  it  no  special  lesson  for  us.  He  came  home 
to  begin  practice  in  1792,  and  in  1795  he  began  to  find 
work.  For  three  years  he  walked  the  streets  of  Philadel- 
phia in  despair.  Finally  he  persuaded  an  older  friend,  a 
Mr.  Prestman,  to  employ  him  to  take  care  of  his  family  at 
a  salary  of  twenty  dollars  a  year.  Several  other  fathers 
of  families  followed  Mr.  Prestman's  example,  and  in  this 
rather  unsatisfactory  fashion  the  young  man  began  to 
earn  his  salt. 

Physick's  biographer  takes  us  through  many  printed 
pages,  and  exhausts  eight  thousand  words  in  explaining 
that  his  hero,  fresh  from  his  studies  and  pining  for 
fame,  did  not  hold  a  position  in  the  Bush  Hill  Hospital, 
which  was  established  by  Stephen  Girard  and  Peter  Helm 
for  the  yellow  fever  victims  in  the  famous  year  1793. 
Other  writers  had  been  in  the  habit  of  saying  that  Bush 
Hill  and  this  epidemic  gave  Physick  his  chance,  but  it 
seems  they  were  mistaken.  He  was  elected  physician  to 
the  Hospital,  but  resigned  the  next  day  because  he  did  not 
wish  to  serve  with  one  Deveze,  a  Frenchman  and  a  new- 
comer, who  appears  to  have  been  a  very  respectable  and 
efficient  person,  if  we  may  judge  from  the  record  of  his 
most  honorable  Hospital  service. 

In  spite  of  his  refusal  to  take  the  Hospital  work, 
Physick  remained  steadfastly  in  town  during  this  and  the 
subsequent  yellow  fever  years,  doing  his  duty  among  the 


214  AIEDICINE    IN    AMERICA. 

poor.  Indeed,  he  himself  had  the  fever  twice, — in  1793 
and  1797, — and  the  second  time  carried  the  depleting 
treatment  so  far  as  to  be  bled  to  the  extent  of  one  hundred 
and  seventy-six  ounces. 

He  did  his  duty  during  those  years  faithfully  and  effi- 
ciently; but,  more  than  that,  he  followed  the  teaching 
of  his  master,  John  Hunter,  and  studied  his  cases,  making 
frequent  autopsies  and  taking  careful  notes.  Those  notes 
formed  the  basis  of  a  systematic  professional  journal 
which  he  continued  until  1810.  His  writings  have  never 
been  edited. 

In  1794  Physick  was  elected  a  surgeon  to  the  Pennsyl- 
vania Hospital,  and  to  that  year,  therefore,  we  must  assign 
the  beginning  of  his  successful  career.  During  this  same 
period  hewas  for  a  short  time  physician  to  the  Philadelphia 
Dispensary.^  Then,  in  the  yellow  fever  epidemic  of  1798, 
the  same  in  which  young  Smith  died,  he  took  service  at 
the  Bush  Hill  Hospital — Deveze  being  no  longer  there — 
and  did  most  admirable  work.  All  say  that  after  this  he 
was  regarded  as  a  man  of  mark  and  was  very  highly 
thought  of  by  his  fellows.  They  made  him  President  of 
the  Academy  of  Medicine  that  same  year,  and  Rush,  in 
his  famous  essay,  frequently  quotes  him.  The  Bush  Hill 
Hospital  managers  appreciated  his  remarkable  talents  and 
usefulness,  and  on  his  retirement  presented  him  with 
some  handsome  plate  as  a  "  Mark  of  their  respectful 
approbation  of  his  Volunteer  and  Inestimable  Services." 

Two  years  after  the  plate  episode  this  exemplary  young 
man  succumbed  to  the  common  lot.  He  fell  in  love  and 
married.    The  lady  was  Miss  Emlen,  "  highly  gifted  and 


^  Necrological  Notice  of  Philip  Syng  Physick,  M.D.,  delivered 
before  the  American  Pliilosophical  Society  by  William  E.  Homer, 
M.D.,  etc. ;  published  in  Bell's  Select  Medical  Library.  A  Discourse 
Commemorative  of  Philip  Syng  Physick,  M.D.,  prepared  by  appoint- 
ment of  the  Faculty  and  Class  of  the  University  of  Louisville,  Jan- 
uary 12,  1838,  by  Charles  Caldwell,  M.D. 


XIX.  CENTURY.     EARLY    SURGEONS.      215 

talented,"  and  "  of  this  union  four  children  were  the 
fruit."  Beyond  that  we  are  told  nothing  further  than  the 
statement  that  Physick  was  a  "  faithful,  domestic  char- 
acter." 

But,  more  important  to  us  than  wife  and  the  resultant 
fruit,  in  the  year  1800  he  was  asked  to  lecture  on  surgery 
to  certain  students  in  the  University  School.  The  lec- 
tures were  encouraged  by  Rush,  who  attended  and  ap- 
plauded; and  here  we  light  upon  a  bit  of  uncomfortable 
professional  gossip.  Shippen  was  the  Professor  of  Sur- 
gery, that  chair  being  combined  with  Anatomy  and  Mid- 
wifery. Caspar  Wistar  was  a  good  surgeon  and  was  ad- 
junct to  Shippen.  Rush  and  Wistar  were  not  on  friendly 
terms,  and  the  veteran  politician,  Rush,  pushed  Physick 
forward  as  Wistar's  rival.  The  trustees  of  the  University 
were  made  to  see  that  so  important  a  chair  as  that  of 
Surgery  should  be  held  by  a  man  devoted  to  that  alone. 
Physick's  admirable  special  lectures  were  attracting  more 
and  more  attention ;  then  who  so  available  for  the  profes- 
sorship of  Surgery?  So  he  became  professor  in  1805. 
One  regrets  Wistar's  disappointment,  if  it  was  a  disap- 
pointment. He  was  seven  years  older  than  Physick, — an 
able,  kindly  man,  a  zealous  student,  and  a  successful,  pop- 
ular teacher;  and  it  would  be  pleasant  to  hear  more  of 
him,  if  there  were  but  time. 

Physick  was  Professor  of  Surgery  for  thirteen  years. 
It  was  during  this  period  that  he  made  his  great  reputation 
and  earned  his  title.  We  may  almost  regard  him  as  the 
mouth-piece,  in  America,  of  John  Hunter.  For  the  first 
time  here  students  heard  something  more  than  theory  and 
a  mere  setting  forth  of  operations  and  technique;  they 
were  taken  to  the  root  of  things  and  made  to  observe,  de- 
duce, and  record. 

Physick  lectured  in  monotonous  style  and  read  his  lec- 
tures from  carefully  prepared  manuscript, — the  same  year 
after  year;    but  his  statements  were  so  sound,  his  obser- 


2i6  MEDICINE    IN    AMERICA. 

vations  so  concise,  and  his  conclusion  so  inevitable  that 
a  great  impression  was  made.  His  hearers  had  to  think; 
and  when  a  man  has  arrived  at  a  clear  conviction  from 
inference,  he  is  apt  to  think  well  of  himself  and  of  his 
preceptor,  too.  And  so  those  hearers  went  out  into  the 
world  and  spread  the  fame  of  the  great  professor. 

These  lectures  were  Physick's  most  conspicuous  con- 
tribution to  surgery;  but,  most  unfortunately,  they  were 
lost  after  the  telling.  He  should  have  published  them. 
He  lived  nearly  twenty  years  after  retiring  from  the  chair; 
but,  so  far  as  known,  the  manuscripts  were  never  revised 
for  the  press  and  have  probably  long  since  been  destroyed. 

Aside  from  his  great  work  as  a  didactic  teacher,  he  was 
widely  famous  as  a  brilliant  hospital  operator  and  clini- 
cian. His  deftness  with  the  knife  was  very  remarkable 
even  in  those  days,  when  ether  and  chloroform  were  un- 
known, and  when  every  second  counted  to  the  anxious 
surgeon  and  the  agonized  patient.  He  was  an  able  me- 
chanic, too.  His  facility  with  apparatus  and  in  that  line 
of  work  which  we  now  call  Orthopedic  Surgery  was  very 
brilliant  and  final.  His  long  training  in  general  medicine, 
also,  had  given  him  a  poise  and  experience  in  dealing  with 
constitutional  diseases  which  was  of  the  greatest  advan- 
tage to  his  surgical  work  and  was  rare  in  that  age.  Like 
most  able  surgeons  of  the  time,  he  was  conservative,  and 
was  thoroughly  in  accord  with  the  teaching  of  John 
Hunter:  "to  perform  an  operation  is  to  mutilate  a  pa- 
tient we  cannot  cure;  it  should  therefore  be  considered 
as  an  acknowledgment  of  the  imperfection  of  our  art." 

Some  of  Physick's  contributions  to  treatment  seem  now 
of  a  rather  humble  nature.  Pie  had  a  sound  practical 
appreciation  of  the  nature  of  wound  healing,  and  much 
of  his  teaching  anticipates  that  of  Paget  and  Gamgee.  Pie 
was  constantly  interested  in  the  treatment  of  fractures, 
and  his  modification  of  Dcsault's  splint  for  fractured  thigh 
is  still  in  common  use.     His  appliance  for  correcting  the 


XIX.  CENTURY.     EARLY    SURGEONS.      217 

outward  displacement  of  the  foot  in  Pott's  "  fracture" 
seems  to  have  been  similar  to,  and  to  have  anticipated, 
that  of  Dupuytren.  He  was  also  successful  with  disloca- 
tions, but  did  not  elucidate  the  mechanism  of  shoulder 
and  hip  luxations,  his  practice  being  to  bleed  the  patient 
to  fainting  and  then  to  reduce  by  the  ancient  barbaric 
methods. 

It  was  lithotomy  that  gave  him  his  greatest  fame.  With 
the  possible  exception  of  Dudley,  he  cut  for  stone  in  the 
bladder  oftener  than  any  other  American  surgeon  of  the 
century,  and  invented  various  ingenious  devices  to  facili- 
tate and  render  safer  the  operation.  In  other  branches 
of  genito-urinary  surgery  he  was  also  a  past  master.  His 
treatment  of  ununited  fractures  by  means  of  the  seton 
added  greatly  to  his  fame,  strangely  enough;  and  he 
devised  a  successful  operation  for  the  closure  of  fecal 
fistula. 

We  noted  in  passing  that  Chief- Justice  Marshall  came 
to  him  for  an  operation.  Both  of  these  distinguished  men 
were  old  at  the  time, — Physick  prematurely  so.  The  aged 
statesman  is  said  to  have  endured  the  operation  with 
remarkable  courage,  and  the  case  is  almost  unique  in 
surgical  annals  for  the  immense  number  of  calculi  re- 
moved. 

These  surgical  feats  and  his  teaching  brought  fame  to 
Physick, — a  fame  which  seems  to  us  in  these  days  almost 
out  of  proportion  to  his  deeds.  He  should  have  put  his 
enormous  experience  and  surgical  knowledge  into  print. 
For  the  lack  of  such  a  book  he  has  become  a  myth  for  us, — 
for  those  of  us  to  whom  he  is  known  at  all.  The  training 
by  Hunter,  the  mind  stored  with  knowledge,  the  clear 
intelligence,  the  remarkable  skill,  were  soon  lost.  They 
died  with  the  man  himself. 

And  of  the  man's  life  there  is  little  more  to  say.  He 
made  a  grievous  mistake  and  cut  himself  oft  from  his 
greatest  usefulness  in  1818. 


2i8  MEDICINE    IN   AAIERICA. 

Young  John  Dorsey  died  in  that  year.  He  had  been 
the  Professor  of  Anatomy,  and  most  successful.  After 
his  nephew's  death  Physick  was  persuaded  to  give  up 
teaching  surgery,  in  which  he  was  a  tower  of  strength, 
and  to  take  the  chair  of  Anatomy,  where  he  became  a 
feeble  reed.  He  was  too  long  out  of  practice.  His  skill 
in  anatomy  had  left  him  and  he  never  got  it  back.  He 
was  too  old  for  change,  but  he  clung  to  the  uncongenial 
work  for  twelve  weary  years  before  he  resigned.  Then, 
with  failing  health  and  sadly,  he  gave  that  up,  together 
with  most  other  work,  and  began  to  withdraw  from  prac- 
tice and  an  active  life. 

One  might  take  Physick  for  a  text  and  ix)int  a  moral, — 
the  unwisdom  of  an  existence  with  but  one  idea.  The 
salient  thing  with  him  was  practice.  He  knew^  nothing 
else.  With  that  gone,  he  existed,  dragging  on  through  five 
solitary,  useless  years,  and  then  he  died. 

His  contemporaries  felt  in  him  the  great  man.  There 
must  have  been  something  which  has  not  come  down  to 
us.  He  was  eulogized  throughout  the  land ;  from  Boston 
to  Louisville,  all  were  agreed.  He  had  been  long  out  of 
the  race ;  no  bitterness  remained ;  all  who  knew  him  spoke 
well  of  him.  It  was  certainly  de  inortuis  nil  nisi  bonuni, 
and  they  buried  him  as  the  "  Father  of  American  Sur- 
gery." 

From  Physick  we  turn  at  once  to  a  man  of  whom  most 
truly  it  must  be  said  that  he  was  not  without  honor,  save 
in  his  own  generation, — Ephraim  McDowell ;  and  from 
Philadelphia  we  plunge  suddenly  into  the  wild  backwoods 
of  the  young  Middle  West. 

There  was  a  fine  type  of  man, — a  rare  man.  It  is  a 
pity  we  know  so  little  of  him.  America  and  the  world  owe 
him  a  great  debt,  only  recently  appreciated.  For  years  he 
went  unknown.  Honest  Stephen  Williams  published  an 
"  American  Medical  Biography"  in  1845,  fifteen  years 
after  McDowell's  death,  and  did  not  so  much  as  refer  to 


XIX.  CENTURY.  EARLY  SURGEONS. 


219 


him,  though  he  found  place  for  dozens  of  simple,  worthy 
souls  like  himself. 

One  would  fain  have  known  that  delightful  McDowell, 
for  he  was  the  very  best  type  of  American  surgeon, — a 
cultivated  man,  living  in  the  wilds,  turning  his  back  upon 
the  old  civilization,  bearing  the  best  science  of  the  times  to 
those  rough,  virile  pioneer  folk.  One  hundred  years  ago 
Danville,  in  the  very  centre  of  Kentucky,  was  a  far-distant 
place,  in  a  rude  country,  little  cultivated  as  yet,  with 
forests  and  bridle-paths  and  Indians,  even,  for  miles  about. 
There,  any  day,  you  might  have  seen  young  McDowell 
riding  rough  through  the  woods  to  visit  his  patients.  It 
was  a  fine  figure  of  a  man, — rising  six  feet,  broad-shoul- 
dered, erect;  a  splendid  horseman;  ruddy,  clean-shaven, 
of  course,  after  the  fashion  of  the  day,  with  keen,  sparkling 
black  eyes  and  a  ready  smile.  He  could  ride  all  day  and  all 
night  without  a  murmur,  and  take  your  leg  off  at  the  end 
of  it  without  winking.  They  relate  a  story  of  his  vigor 
when  a  student  in  Edinburgh.  A  young  Irishman  came 
along,  telling  of  his  own  prowess  in  running  and  jump- 
ing and  many  other  things  that  they  do  in  Ireland.  He 
challenged  the  whole  class  to  make  a  match  for  him,  and 
they  chose  McDowell. 

The  first  race  was  sixty  yards  for  a  purse  of  ten 
guineas.  The  American  let  himself  be  beaten.  A  few 
days  later  there  was  a  second  race  for  two  hundred  yards 
and  a  hundred  guineas.  As  we  should  say  to-day,  Mc- 
Dowell "  wiped  the  ground"  with  the  talkative  young  man 
from  Ireland.  How  modern  sporting  ethics  would  regard 
"  throwing"  that  first  race  is  an  interesting  question. 

Ephraim  McDowell  was  born  on  November  11,  1771, 
in  Rockbridge  County,  Western  Virginia,  and  came  of 
that  sturdy  Scotch  Presbyterian  stock  which  has  done  so 
well  by  this  land  of  ours.  His  father  was  Samuel  McDow- 
ell, an  important  man  in  his  place, — lawyer,  judge,  and 
legislator.    In  1755  he  had  married  a  Miss  McClung,  also 


220  MEDICINE    IN   AMERICA. 

Scotch  and  Virginian.  To  these  two  were  born  twelve 
children,  of  whom  Ephraim  was  the  ninth. 

After  the  Revolution,  when  Virginia  was  settling  the 
claims  of  its  veterans  and  was  allotting  lands  out  of  its 
Kentucky  territory,  Samuel  McDowell  was  sent — one  of 
a  Commission,  in  1782 — to  adjust  those  Western  grants. 
So  he  came  to  Danville  and  settled  there,  and  was  ap- 
pointed Judge  of  the  District  Court;  and  there  he  lived 
out  his  days,  dying,  indeed,  in  181 7,  after  his  son  had  done 
his  greatest  work.  — 

It  was  in  that  vigorous  frontier  life  that  young  McDow- 
ell grew  up,  getting  what  rambling  education  was  to  be 
found  in  the  "  Classical  Seminary"  of  Messrs.  Worley  and 
James,  who  migrated  between  Bardstown  and  George- 
town, and  seeing  that  strange  Old- World  life — it  seems  to 
us  now — among  gentlemen  pioneers,  farmers,  woodsmen, 
hunters,  Indians,  and  negro  slaves,  of  which  the  simple 
old  novelists  used  to  tell,  long  years  "  before  the  war." 

So  McDowell  came  to  be  an  active,  wholesome,  clear- 
headed lad,  with  a  smattering  of  book-learning,  a  little 
Greek  and  Latin,  and  a  keen  love  of  nature.  He  was  given 
to  shooting  and  riding  more  than  to  study,  but  he  did 
acquire  some  acquaintance  with  good  literature,  which 
later  he  came  to  love  with  a  sure  taste  and  devotion.  He 
knew  good  writing,  but  his  own  composition  was  rough 
and  obscure  always.  It  was  like  his  love  of  music.  He 
rejoiced  in  that,  but  his  violin  playing  was  a  penance  to 
his  devoted  family. 

He  did  not  settle  down  to  serious  work  until  he  was 
almost  a  man  grown.  His  father  was  well  to  do  and  busy, 
and  the  son  found  occupation  enough  in  helping  him  and 
following  the  rough  country  life.  When  twenty  years  old, 
however,  he  concluded  to  study  some  profession,  and,  see- 
ing the  opportunity  for  a  good  doctor  in  his  own  rapidly 
growing  State,  decided  on  medicine.  Perhaps,  as  Gross 
says,  it  is  a  pity  he  die]  not  go  to  the  Philadelphia  School; 


XIX.  CENTURY.     EARLY    SURGEONS.      221 

though  I  fancy  that  would  have  been  no  better  than  the 
course  actually  followed.  He  wanted  a  preceptor  to  begin 
with,  according  to  the  fashion,  and  there  being  none  com- 
petent near  Danville,  he  went  back  to  his  old  home  in 
Virginia  and  entered  the  family  of  a  Dr.  Humphreys,  of 
Staunton,  about  thirty  miles  from  his  native  place. 
Humphreys  was  a  graduate  of  Edinburgh,  and  is  mem- 
orable to  us  only  as  McDowell's  early  chief.  He  was  a 
busy,  self-centred  man,  who  was  struggling  with  a  large, 
scattered  practice,  and  had  little  time  for  his  occasional 
pupils.  That  was  a  pity,  because  McDowell  wasted  two 
years  with  him.  Neither  master  nor  man  was  a  student, 
and  without  the  stimulus  of  competition  the  lad's  work 
was  desultory  enough.  Finally  his  shrewd  old  father 
grasped  the  situation  and  sent  him  off  to  Edinburgh,  by 
Humphreys's  advice,  to  make  up  for  lost  time. 

The  old  Scotch  school  was  never  stronger  than  during 
the  last  ten  years  of  the  eighteenth  century,  and  McDowell 
was  there  in  1793  and  1794 — memorable  years,  when  we 
turn  our  eyes  back  to  Philadelphia  and  recall  the  great 
work  of  Rush  and  the  sad  trampings  of  Physick  "  looking 
for  business." 

In  Edinburgh,  at  last,  McDowell  got  his  inspiration. 
It  comes  late  to  many  a  strong  man,  and  it  came  late  to 
him.  Gregory  and  Black  and  Munro  (the  second)  were 
the  great  men  there,  —  popular  and  eloquent  teachers. 
Speaking  of  this  period  in  McDowell's  life,  a  memoir 
writer  says,  "  We  may  imagine,  moreover,  that  one  just 
fresh  from  the  wilds  of  America  must  have  felt  no  little 
restraint,  and  even  embarrassment  in  the  polished  and  re- 
fined circle  of  students  in  the  modern  Athens."  Fancy 
the  joy  of  those  polished  students  could  they  have  heard 
that.  We  know  fairly  well  what  sort  of  young  barbarians 
were  the  medical  students  of  a  hundred  years  ago,  and 
doubtless  the  jolly  Kentuckian  did  find  some  trouble  in 
keeping  his  end  up  with  them. 


222  MEDICINE    IN    AMERICA. 

But  John  Bell  was  his  hero. 

Bell  was  not  as  )^et  giving  the  lectures  on  surgery  at  the 
University,  but  McDowell  took  one  of  his  private  courses, 
and  rejoiced  in  the  fact  for  the  rest  of  his  life.  It  was 
later  that  Bell  became  Professor  of  Anatomy,  Surgery, 
and  Obstetrics,  and  wrote  his  "  Principles  of  Surgery," 
which  was  being  published  from  1801  to  1807;  but  in 
those  earlier  years  he  was  doing  his  greatest  work  as  a 
teacher,  and  McDowell  had  the  full  benefit  of  his  fertile 
discourses.  The  modern  system  of  clinical  teaching  was 
then  little  known,  but  Bell  did  far  more  of  a  certain  sort  of 
clinical  lecturing  than  most  men  of  his  day.  He  operated 
in  a  masterful  fashion  and  expounded  lucidly  while  he 
worked,  meantime  keeping  the  students  constant  in  their 
attention  by  skilful  questioning  and  requests  for  their 
assistance.  He  was  certainly  the  most  popular  teacher  of 
his  time  in  Edinburgh,  his  secret  being  that  his  thought 
was  all  for  the  improving  of  his  pupils  and  not  for  the 
airing  of  his  own  hobbies  and  opinions.  All  things  con- 
nected with  the  art  of  obstetrics  and  the  diseases  peculiar 
to  women  interested  him  especially.  He  was  a  very  hu- 
man person,  and  in  his  dissections  used  to  point  out  how 
frequently  woman's  pelvic  organs  were  diseased  and  how 
impotent  surgery  was,  as  yet,  for  the  relief  of  those  con- 
ditions. He  would  commiserate  especially  the  unfortu- 
nate women  afflicted  with  ovarian  tumors,  and  lament  that 
these  growths,  usually  so  benign  in  structure,  should  de- 
stroy life  by  their  great  and  obstructing  size  merely.  He 
was  an  unusual  man  with  an  unusual  method,  and  he  fired 
our  generous  young  American  with  a  love  of  his  profes- 
sion and  an  enthusiasm  for  study  which  increased  con- 
stantly through  life.  Bell  taught  his  students  how  to 
work,  and  that  is  a  knowledge  whicli,  once  acquired,  is 
never  lost. 

Those  were  very  important  years  in  McDowell's  life, 
and  he  never  tired  afterwards  of  telling  the  tale. 


XIX.  CENTURY.     EARLY    SURGEONS.      223 

He  had  a  chum  at  Edinburgh,  —  an  American,  after- 
wards distinguished, — Samuel  Brown,  who  became  a  suc- 
cessful teacher  of  medicine  in  the  Transylvania  Univer- 
sity. He  was  a  brother  of  the  well-known  James  Brown, 
our  minister  to  France. 

One  would  be  glad  to  linger  over  this  period  in  McDow- 
ell's life.  He  was  surrounded  by  men  of  his  own  kind, 
and,  being  without  a  college  education  at  home,  Edin- 
burgh became  to  him  truly  an  ahna  mater.  But  he  was 
coming  on  in  years,  the  paternal  purse  was  burdened  with 
eleven  other  demands  upon  it,  and  so  it  was  incumbent 
upon  him  to  begin  making  his  way.  We  see  that  his  years 
of  study  were  few, — far  fewer,  indeed,  than  Morgan's  or 
Rush's  or  Physick's  or  some  others;  but,  even  so,  his 
time,  such  as  it  was,  was  well  spent  after  leaving  good 
Dr.  Humphreys — far  better  spent  than  that  of  the  great 
majority  of  American  students  of  the  time. 

It  was  a  pity  that  he  had  to  go  home  when  he  did  (early 
in  1795),  for  he  could  not  complete  his  course  and  qualify 
for  the  doctor's  degree.  As  we  have  seen,  the  doctor's  de- 
gree was  a  rare  prize  in  America  one  hundred  years  ago. 
Men  practised  without  it,  none  hindering,  and  their  friends 
gave  them  the  title  by  brevet. 

McDowell  had  been  correct  in  his  prognostication  that 
there  would  be  a  wide  field  in  Kentucky  for  a  good  doctor. 
He  went  home  at  once,  to  Danville,  and  there  he  lived 
ever  after,  from  the  outset  wellnigh  swamped  with  a  great 
burden  of  practice.  For  years  he  met  with  almost  no 
competition.  The  reputation  of  good  work  done  with 
John  Bell  preceded  him,  and,  until  Dudley  came,  years 
afterwards,  there  was  no  other  surgeon  in  the  State.  In- 
deed, his  labors  covered  much  of  that  region  known  as  the 
Middle  West,  and  his  excursions  took  him  into  Ohio,  Ten- 
nessee, and  places  even  more  distant. 

Of  course  he  married  (that  was  in  1802),  and  had  chil- 
dren,— eight   of   them.      His   wife   was    Sarah    Shelby, 


224  ^lEDICINE    IN    AMERICA. 

daughter  of  the  Governor  of  the  State,  renowned  for  her 
beauty  even  in  that  country  of  beautiful  women. 

All  these  facts  we  must  make  a  note  of :  how  this  young 
McDowxll  came  of  good  stock,  was  the  son  of  an  able 
father,  was  unusually  w^ell  educated  for  his  place  and  time, 
was  connected  by  marriage  wath  one  of  the  most  distin- 
guished citizens  of  his  State,  and  w^as  famous  over  a  great 
region  for  his  professional  attainments.  We  must  make 
this  note  because,  later,  when  his  great  work  was  pub- 
lished, it  was  sneeringly  said  that  what  was  related  therein 
was  untrue,  for  such  things  could  not  come  from  an  igno- 
rant, unknown  backwoods  doctor. 

In  1809,  when  thirt3^-eight  5'-ears  old  and  fourteen  years 
in  practice,  Ephraim  McDowell  performed  ovariotomy. 
It  had  never  been  done  before.  For  centuries  surgeons 
had  regarded  it  as  impossible ;  but  out  of  the  American 
wilderness  came  the  pioneer  to  show  the  way. 

It  is  difficult  for  us  at  the  present  day  to  estimate  what 
this  operation  has  done  for  women.  Peaslee,  writing 
thirty  years  ago,  stated  "  that  in  the  United  States  and 
Great  Britain  alone  ovariotomy  has,  within  the  last  thirty 
years,  directly  contributed  more  than  thirty  thousand 
years  of  active  life  to  women."  But  when  Peaslee  wrote 
ovariotomy  was  in  its  infancy.  The  development  of  mod- 
ern surgery  has  increased  its  possibilities  almost  beyond 
computation ;  and  it  is  probably  well  within  bounds  to 
assert  that  by  this  operation,  in  the  United  States  alone, 
there  are  annually  added  a  million  years  to  the  lives  of  our 
countr}^women. 

In  the  autumn  of  1809  McDowell  was  consulted  by  a 
Mrs.  Crawford,  the  subject  of  a  large  ovarian  cyst.  She 
deserves  some  share  of  our  gratitude.  Here,  we  are  told, 
was  the  case  he  had  been  waiting  for.  The  teachings  of 
John  Bell  had  sunk  deep  in  his  mind,  and  he  had  the  cour- 
age which  that  great  surgeon  lacked.  Mrs.  Crawford 
was  a  woman  of  unusual  vigor  of  mind  and  body,  and 


XIX.  CENTURY.     EARLY    SURGEONS.      225 

McDowell  put  the  case  plainly  to  her.  She  understood 
that  the  operation  was  an  experiment,  that  it  had  never 
been  done  before,  and  that  the  danger  was  great ;  but,  on 
the  other  hand,  that  the  permanence  of  the  cure  was  cer- 
tain, and  that,  without  operation,  her  own  early  death  was 
equally  certain.  In  the  face  of  these  facts  she  decided  to 
have  it  done.  One  must  remember  that  this  was  before 
the  days  of  ether;  and  for  the  benefit  of  the  layman  reader 
it  must  be  explained  that  ovariotomy  implies  opening  the 
peritoneal  cavity,  and  that  one  hundred  years  ago  the 
peritoneal  cavity  was  a  terra  incognita  to  surgeons,  for  its 
exposure  was  supposed  to  mean  peritonitis  and  death. 
Antiseptic  surgery  was  not  born  until  nearly  sixty  years 
thereafter. 

But  McDowell  did  not  go  to  work  without  encountering 
some  opposition,  and  that  from  an  unexpected  quarter. 
His  nephew,  James  McDowell,  who  had  been  educated  by 
him  and  had  recently  returned  home  from  the  Philadel- 
phia Medical  School,  was  with  him  at  the  time  as  junior 
partner,  and  his  opinion  was  entirely  against  operating. 
We  must  remember  that  he  was  fresh  from  the  influence 
of  the  cautious  and  conservative  Physick,  whom  w^e  can- 
not conceive  of  as  stepping  off  into  any  strange,  unex- 
plored fields.  The  younger  McDowell  was,  however,  per- 
suaded to  assist  by  the  consideration  that,  should  the 
patient  die,  his  uncle  would  bear  the  responsibility,  and 
should  she  recover,  he  himself  might  absorb  some  of  the 
reflected  glory. 

Mrs.  Crawford  drove  sixty  miles  to  McDowell's  house 
and  was  operated  upon  there.  No  preparation  of  the 
patient  was  made  beyond  giving  her  a  huge  dose  of 
opium.    The  account  runs  quaintly : 

"  The  patient  being  on  the  table,  I  marked  with  a  pen 
the  course  of  incision  to  be  made;  desiring  him  (nephew 
James)  to  make  the  external  opening,  which  in  part  he  did. 
I  then  took  the  knife,  and  completed  the  operation,  as 

15 


226  MEDICINE    IN   AMERICA. 

stated  in  the  Medical  Repertory.  Although  the  termina- 
tion of  this  case  was  most  flattering,  yet  I  was  more  ready 
to  attribute  it  to  accident  than  to  any  skill  or  judgment 
of  my  own;  but  it  emboldened  me  to  undertake  similar 
cases;  and  not  until  I  had  operated  three  times — all  of 
which  were  successful — did  I  publish  anything  on  the 
subject.  I  then  thought  it  due  to  my  own  reputation  and 
to  suffering  humanity  to  throw  all  the  light  which  I  pos- 
sessed upon  diseased  ovaria." 

That  is  an  interesting  picture,  worthy  of  Rembrandt. 
The  rough  "  surgery"  of  the  frontier  doctor,  the  cour- 
ageous woman  mounting  the  operating-table,  the  forceful, 
determined  man  daring  to  risk  another's  life  in  a  fashion 
never  before  attempted, — any  man  dare  risk  his  own, — 
and  the  timid  assistant,  shrinking  from  putting  forth  his 
hand  into  the  unknown.  We  have  seen,  from  McDowell's 
own  words,  how  he  was  obliged  to  take  the  knife  himself, 
and  we  may  well  imagine  the  relief  of  nephew  James.  The 
operation  seems  to  have  been  done  at  a  maximum  of  speed 
and  with  a  minimum  of  shock.  The  patient  made  a  rapid 
recovery  and  survived  more  than  thirty  years.^ 

For  a  time  McDowell  said  no  word  about  it,  and  among 
the  ignorant  country  people  of  the  region  the  meaning  of 
it  all  was  as  nothing.  He  waited  three  years,  when  he 
had  another  equally  successful  case,  and  the  next  year 
another.  Then  he  was  induced  to  tell  what  he  had  done. 
He  was  induced  with  difficulty,  for  he  was  a  modest  man 
and  thought  three  successful  cases  insufficient;  but  his 
friends,  who  knew,  thought  differently,  and  at  last  per- 
suaded him  with  the  argument  that  he  owed  it  to  his  old 
master,  John  Bell,  to  show  how  that  early  teaching  had 
borne  fruit. 

Unfortunately,  McDowell  had  never  kept  any  proper 


'Eclectic  Repertory  and  Analytic  Review,  vol.  vii.  p.  242,  Phila- 
delphia, April,  1817. 


XIX.  CENTURY.     EARLY    SURGEONS.      227 

clinical  records  of  his  cases,  so  that  the  publication  was 
very  unsatisfactory  in  form,  though  the  substance  was 
all  there.  Finally  he  drew  up  a  sketch  of  his  three  cases, 
referring  to  his  ledger  for  the  dates  and  to  his  memory 
for  the  details.  The  account  is  short  and  carries  convic- 
tion. A  copy  of  this  paper  was  sent  to  Bell  in  Edinburgh, 
but  that  surgeon  never  received  it.  He  was  ill  in  Italy  at 
the  time  and  died  there. 

Another  copy  of  the  report  was  sent  by  William  A. 
McDowell,  his  nephew  and  a  physician,  to  Physick  in 
Philadelphia,  with  the  request  that  if  found  worthy  it 
might  be  published  in  some  medical  journal.  Physick 
treated  it  characteristically ;  perhaps  we  should  say,  cava- 
lierly. He  suppressed  it,  or,  at  any  rate,  he  ignored  and 
did  not  publish  it.  There  is  an  interesting  subject  for  re- 
flection. The  "  Father  of  American  Surgery"  threw  away 
the  chance  of  proclaiming  the  greatest  gift  to  surgery  ever 
yet  made  in  America.  He  did  not  act  maliciously  or  from 
jealousy.  He  was  merely  obstinate,  contemptuous,  or 
shall  we  call  it  dull  ?  Doubtless  he  thought  McDowell  an 
ignorant  person  who  was  trying  to  impose  on  him.  He 
was  so  discourteous  as  not  even  to  acknowledge  the  receipt 
of  the  paper. 

William  McDowell,  the  loyal  nephew,  was,  however, 
not  to  be  discouraged,  even  by  a  "  Father  of  Surgery." 
He  was  a  Philadelphia  graduate  himself,  and  found  other- 
means.  He  took  his  story  to  Thomas  C.  James,  the  Pro- 
fessor of  Midwifery,  and  got  a  courteous  and  ready  hear- 
ing. James  was  a  fine  type  of  the  able,  cultivated  physi- 
cian, free  from  guile  and  generous  to  quixotism ;  the  most 
beloved  and  popular  medical  teacher  in  Philadelphia.  He 
saw  the  meaning  of  this  new  thing,  and  appreciated  that 
that  had  come  to  pass  which  for  centuries  surgeons  had 
hoped  for  in  vain.  Supplied  with  copies  of  the  cases,  he 
promptly  published  them  in  the  Eclectic  Repertory,  of 
which  he  was  an  editor,  and  then  told  his  classes  and  the 


228  MEDICINE    IN    A:\IERICA. 

profession  what  he  had  heard.  But  it  all  went  for  naught. 
The  published  cases  were  unnoticed  or  were  disbelieved. 
Indeed,  so  slight  was  the  impression  made  that  four  years 
later,  in  1821,  the  distinguished  Yale  professor,  Nathan 
Smith,  repeated  the  operation  and  reported  it  as  his  own, 
in  perfectly  good  faith. 

That  account  sent  to  Bell  got  about,  however,  and 
caused  much  comment  of  one  kind  or  other.  For  a  time 
the  paper  lay  unopened;  then,  upon  Bell's  death,  it  fell 
into  the  hands  of  a  Mr.  Lizars,  an  Edinburgh  surgeon, 
who  was  much  impressed  by  it.  Unfortunately  for  Lizars, 
he  was  unskilled  in  diagnosis ;  but  his  lack  of  skill  led  to 
the  publication  of  AIcDowell's  paper.  Lizars  had  a  patient 
of  enormous  girth,  from  whom  he  now  proposed  to  remove 
an  ovarian  tumor;  the  patient  submitted  and  the  incision 
was  made,  when,  to  the  horror  of  ]\Ir.  Lizars  and  the 
grievous  discomfort  of  the  patient,  it  was  found  that  her 
complaint  was  simply  fat.  In  justification  of  what  seemed 
to  be  so  unwonted  a  performance,  Lizars  published  ]Mc- 
Dowell's  paper.^ 

He,  at  least,  seems  to  have  believed  the  reports,  but 
most  authorities  were  either  silent  or  contemptuous.  It 
is  not  a  pleasant  chapter  in  medical  annals,  and  shows 
animus  which  we  like  to  believe  our  latter-day  scientific 
spirit  has  obliterated.  Because  a  man  has  done  a  task  in 
which  you  have  failed,  is  that  any  reason  for  calling  him 
a  scoundrel  or  a  liar?  That  is  the  meaning  of  what  hap- 
pened to  McDowell,  and  it  has  happened  in  the  world  of 
science  before  and  since.  I  am  afraid  we  are  all  very 
human.  Jenner  and  Morton  and  Lister  and  Pasteur  were 
subjected  to  the  ignorant  abuse  of  men  successful  in  their 
own  fields.  There  are  two  kinds  of  scepticism,  the  honest 
and  the  stupid.  One  man  is  a  sceptic  because  he  has  seen 
the  shattering  of  many  glorious  castles  in  Spain ;   but  he 


*  Edinburgh  Medical  and  Surgical  Journal,  vol.  xxxii.,  1824. 


XIX.  CENTURY.     EARLY    SURGEONS.      229 

reserves  his  verdict,  and  is  ready  with  open  mind  to  give 
his  opinion  after  the  arguments  are  heard.  But  alas !  the 
stupid  sceptic  is  quite  as  common;  the  dull,  jealous  man, 
who  prides  himself  on  disbelieving,  without  inquiry, 
whatever  he  hears,  and  calls  upon  the  world  to  applaud  his 
shrewdness. 

James  Johnson,  the  editor  of  the  Medico-Chirurgical 
Review,  of  London,  belonged  to  the  latter  class.  He  was 
cheap,  too,  and  wrote  of  McDowell's  first  case,  "  Dr.  Mac 
visited  the  patient  at  the  end  of  five  days,  though  she  had 
come  to  his  own  residence  to  have  the  operation  per- 
formed. He  found  her  engaged  in  making  her  bed.  She 
soon  returned  to  her  native  place  quite  well.  Credat 
JudcBus,  non  ego/'  "  A  back  settlement  of  America — 
Kentucky — has  beaten  the  mother  country,  nay,  Europe 
itself,  with  all  the  boasted  surgeons  thereof,  in  the  fearful 
and  formidable  operation  of  gastrotomy,  with  extraction 
of  diseased  ovaries."  "  We  cannot  bring  ourselves  to 
credit  the  statement."  Such  were  some  of  the  comments 
of  the  wise  men  of  Europe.  Then  there  were  others  who 
attempted  to  show  that  McDowell  could  not  rightly  claim 
precedence.  These  statements  have  been  carefully  ana- 
lyzed and  refuted  by  S.  D.  Gross,  who  demolishes  the 
claims  of  earlier  operators  by  showing  that  the  operations 
were  undertaken  for  other  conditions,  or  that  ovaries  were 
merely  cut  down  upon  without  being  removed. 

One  source  of  error  which  even  Gross  has  not  pointed 
out  is  the  modern  misuse  of  the  term  ovariotomy,  con- 
fusing it  with  ovariectomy.  For  instance,  the  famous 
operation  of  L'Aumonier,  of  Rouen,  performed  in  1776, 
was  literally  ovariotomy.  He  cut  down  upon  and  opened 
an  abscess  of  the  ovary ;  but  he  did  not  remove  the  organ, 
and  that  is  what  ovariotomy  has  come  to  mean  in  modern 
parlance. 

After  all,  the  controversy  soon  ceased  for  want  of  the 
fuel  which  McDowell  refused  to  supply.     He  was  a  quiet 


230  MEDICIXE    IX    AMERICA. 

man  who  was  willing  to  let  his  deeds  speak  for  themselves 
with  posterity.  He  did  thirteen  ovariotomies  in  all ;  but, 
unfortunately,  we  cannot  be  sure  of  his  mortality-rate, 
though  we  know  that  eight  of  his  cases  recovered. 

Nine  years  after  his  first  reports  he  saw  fit  to  publish 
a  vindication  of  his  work,  and  addressed  it  to  the  ph3^si- 
cians  of  the  West,  more  particularly  to  the  medical  faculty 
and  class  at  Lexington,  Kentucky.  This  vindication  is 
merely  a  resume  of  his  previous  articles,  and,  though  in- 
teresting, was  not  needed.  Slowly  indeed  the  greatness 
of  the  thing  he  had  done  came  home  to  the  profession; 
other  men  followed  in  his  footsteps,  but  timidly  at  first; 
and  it  was  not  till  Lister's  time  that  the  practice  came 
universally  to  be  applied,  until  to-day,  with  our  modern 
methods,  ovariotomy  has  become  one  of  the  most  use- 
ful, most  common,  and  safest  of  the  operations  of  major 
surgery. 

Of  course,  ^McDowell's  surgical  practice  covered  other 
fields,  and  in  many  of  them  he  was  successful,  though  not 
remarkable.  He  was  a  cautious  and  safe  operator,  fol- 
lowing the  best  opinion  of  his  time.  Like  Physick  and 
Dudley,  later,  he  was  a  distinguished  lithotomist,  and  two 
years  before  his  death  had  collected  a  total  of  thirty-two 
cases  without  a  death.  Like  Physick,  too,  he  had  a  very 
conspicuous  man  among  his  lithotomy  patients, — James 
K.  Polk,  afterwards  President.  Polk  was  an  illiterate  boy 
when  the  operation  was  done ;  and  his  letters  to  McDowell 
at  the  time  are  interesting  when  compared  with  a  letter  to 
the  same  correspondent,  written  fourteen  years  later,  when 
he  had  partially  educated  himself  and  was  a  Representa- 
tive in  Congress. 

McDowell  had  the  courage  and  perseverance  to  become 
and  remain  a  good  anatomist,  and  that  by  persistent  prac- 
tice in  dissecting.  In  some  fashion  he  managed  to  secure 
subjects  for  such  work,  and  he  not  only  insisted  that  his 
pupils  should  constantly  dissect,  but  whenever  he  had  a 


XIX.  CENTURY.     EARLY    SURGEONS.      231 

major  operation  in  prospect,  he  always  rehearsed  the 
appropriate  anatomy  on  the  cadaver. 

Though  broken  in  health  before  old  age  by  reason  of 
his  incessant  toil  and  grave  responsibilities,  he  kept  up  the 
fight  and  extended  constantly  his  multifarious  interests. 
He  was  not  altogether  unknown  or  neglected  in  the  East 
as  time  went  on.  Even  before  his  first  abdominal  section 
the  Medical  Society  of  Philadelphia  sent  him  its  diploma, 
in  1807;  and  in  1825  the  University  of  Maryland  made 
him  an  alumnus  with  the  honorary  M.D.  That  pleased 
him  mightily. 

As  he  grew  older  he  found  time  for  more  reading,  since 
money  had  been  earned  and  he  had  partners  to  help  him. 
Not  only  did  he  read  all  that  was  then  produced  by  con- 
temporary medical  writers,  but  he  was  a  capital  Latinist 
and  Grecian  and  a  delighted  student  of  all  good  literature. 
Except  his  one  great  accomplishment,  he  produced 
nothing  more  that  has  come  down  to  us;  but  let  that 
suffice. 

A  kindly,  big-souled  optimist,  he  went  through  life, 
demanding  little  of  the  world  and  giving  much.  In  his 
later  years  Dudley  came  to  divide  the  honors  with  him 
in  that  Western  country,  but  he  felt  no  jealousy  and 
recognized  the  superior  equipment  of  the  younger  man. 

He  died,  and  the  memory  of  him  was  forgotten,  almost, 
as  also  that  work  of  his,  accomplished  two  generations 
before  its  time.  Other  men  and  other  countries  came  to 
be  looked  to  for  the  thing  that  he  had  first  done  so  well ; 
but  tempus  omnia  revelat,  and  at  last  McDowell's 
thoughtless  countrymen,  even,  have  come  to  see  that  on 
our  frontier,  a  hundred  years  ago,  there  lived  one  of 
the  greatest  of  American  surgeons. 


CHAPTER    X. 

THE    NINETEENTH     CENTURY.        EARLY    SURGEONS     (CON- 
TINUED). 

We  have  had  some  ghmpse  of  two  of  our  early  sur- 
geons, Physick  and  McDowell,  and  of  their  predecessors, 
Jones,  Shippen,  and  John  Warren.  Our  annals  name 
three  other  men  whose  work  was  done  largely  in  the  first 
half  of  the  nineteenth  century, — Mott,  John  C.  Warren, 
and  Dudley.  They  were  all  very  eminent  in  their  time, 
and  their  influence  for  good  was  greater  than  we  are  wont 
to  realize  in  these  latter  days.  There  were  many  others 
at  whom  we  must  glance,  but  those  already  named  were 
the  most  conspicuous. 

Two  things  about  all  these  men  and  about  their  disciples 
and  followers  are  continually  salient,  their  daring  and 
their  ingenuity, — traditional  American  traits.  As  Billings 
says,  they  may  not  have  contributed  many  great  things 
to  the  sum  of  human  knowledge,  they  may  not  conspicu- 
ously have  advanced  science  in  the  narrow  sense,  nor  de- 
voted themselves  to  experimental  research — those  are  the 
deeds  and  pursuits  of  a  wider  and  more  leisured  civiliza- 
tion, reserved  in  our  country  for  modern  times  and  the 
twentieth  century;  but  they  did  show  the  world  how  to 
apply  the  knowledge  at  command,  that  desperate  cases 
need  desperate  remedies,  and  that  theory  avails  little  with- 
out the  courage  to  put  it  into  practice.  So  we  must  think 
of  those  early  years  as  producing  men  of  unusual  re- 
source, ingenuity,  and  courage;  the  best  of  them  well 
educated  and  putting  into  service  the  best  teaching  of  the 
Old  World. 

But  at  the  same  time,  in  all  fairness,  one  must  not  lose 
sight  of  the  fact  that  the  great  mass  of  our  doctors, 
232 


XIX.  CENTURY.     EARLY    SURGEONS.      233 

though  often  devoted,  hard-working,  and  faithful  men, 
were  sadly  undereducated.  They  had  the  ingenuity  and 
the  courage,  perhaps,  but  not  the  knowledge;  so  that 
many  grievous  sins  against  nature  must  be  laid  to  their 
account,  though  occasionally  some  one  man  might  hit 
upon  a  brilliant  discovery.  That  class  of  men — able, 
honest,  but  untrained — is  rapidly  disappearing  from 
among  us,  thanks  to  the  growth  of  the  scientific  spirit, 
and  the  country  is  not  now  lacking  in  qualified  doctors, 
with  a  tendency,  let  us  hope,  to  constant  improvement. 
But  there  still  remains  with  us,  and  in  larger  measure 
than  other  countries  know,  a  great  class  of  specious, 
dishonest,  and  untrained  men  whom  our  laws  do  not 
reach.  Of  such  it  is  needless  to  speak  further  here,  be- 
yond making  this  note  in  passing,  that  large  numbers  of 
unthinking  mankind  always  have  liked  and  always  will 
like  to  be  cozened,  and  that  when  osteopathy,  Christian 
science,  and  similar  delusions  have  passed  from  us  and 
from  memory,  other  forms  of  quackery  and  pseudo- 
science  will  arise  to  supply  the  demand.  Wherever  true 
science  fails,  still  struggling  to  solve  great  problems, 
there  humbug  steps  in  and  claims  its  victories. 

Among  those  early  surgeons  and  great  teachers  none  is 
better  known  to  us  by  name  than  Valentine  Mott.  His 
long  life  seems  almost  to  have  made  him  a  modern,  for  he 
died  after  the  war  between  the  States ;  but  his  birth  date 
was  in  the  eighteenth  century  and  his  best  work  was  done 
in  the  generation  of  our  great-grandfathers.  His  story 
has  been  eloquently  told  by  a  famous  American  surgeon,^ 
whose  formal  phrases  are  still  pleasant  in  modern  ears. 

Valentine  Mott  was  the  great  New  York  surgeon  sev- 
enty-five years  ago.  He  was  born  at  Glen  Cove,  Long 
Island,  August  20,  1785.      His  father,  Henry  Mott,  was 


'  Memoir  of  Valentine  Mott,  M.D.,  LL.D.,  by  S.  D.  Gross,  M.D., 
LL.D.,  Philadelphia,  1868. 


234  AIEDICIXE    IN   AMERICA. 

a  respectable  physician  who  hved  a  long  life  and  died  in 
1840.     The  Alotts  were  Quakers. 

The  great  surgeon  was  of  a  quiet,  even,  kindly  tem- 
perament, influenced,  doubtless,  by  his  Quaker  training, 
though  in  his  old  age  he  became  a  communicant  in  the 
Episcopal  Church.  He  went  to  school  in  Newtown, 
where  his  father  lived  at  that  time,  and,  like  his  distin- 
guished Boston  contemporary,  Jacob  Bigelow,  he  was  so 
well  grounded  in  Greek  and  Latin  that  he  continued  his 
love  for  their  great  classics,  and  read  them  so  long  as  he 
lived.  He  did  not  take  a  degree  in  arts  at  any  college, 
but  worked  on  at  home,  and  began  the  study  of  medi- 
cine in  1804  at  the  age  of  nineteen.  Valentine  Seaman, 
his  kinsman,  a  well-equipped  man  and  a  surgeon  to  the 
New  York  Hospital,  was  his  preceptor.  While  living 
with  him  Mott  took  the  usual  two  courses  of  lectures  at 
the  old  Columbia  Medical  School,  and  in  1806  was  grad- 
uated thence  with  the  M.D.  degree.  Such  was  the  inade- 
quate practice  of  the  time,  not  yet  progressing  beyond 
what  we  saw  in  Philadelphia  some  thirty  years  before. 

But  his  subsequent  training  was  interesting.  He  went 
abroad,  studied  with  great  men,  and  became  acquainted 
with  many  distinguished  persons  and  places  and  things. 

During  this  visit  all  his  time  was  spent  in  England  and 
Scotland,  and  one  feels  that  such  experiences  had  much  to 
do  with  shaping  his  career.  The  two  years  spent  in  Great 
Britain  were  more  full  of  variety  and  general  interest 
than  falls  to  the  lot  of  most  students.  Mott  went  pro- 
vided with  excellent  letters  of  introduction,  and  met  and 
knew  many  men  outside  of  his  own  profession. 

Before  this  visit  he  showed  no  evidence  of  any  great 
interest  or  skill  in  surgery,  his  graduation  thesis  itself 
being  "  An  Experimental  Inquiry  into  the  Chemical  and 
Medicinal  Properties  of  the  Statice  Limonium  of  Lin- 
naeus." 

It  was  in  the  spring  of  1807  that  Mott  reached  London. 


XIX.  CENTURY.     EARLY    SURGEONS.      235 

and  he  was  twenty-two  years  old.  That  was  two  years 
before  McDowell's  first  ovariotomy,  Physick  was  then  a 
rising  surgeon  and  lecturer,  the  Revolutionary  Warren 
was  still  in  mid-career,  and  John  C.  Warren  was  begin- 
ning his  professional  life  in  Boston,  in  association  with  his 
distinguished  father. 

In  the  first  decade  of  the  nineteenth  century  London  was 
rich  in  famous  surgeons ;  indeed,  surgery  was  then  in  the 
ascendant  there.  The  life  and  work  of  John  Hunter  were 
still  recent,  and  the  impulse  which  he  had  given  to  science 
was  apparent  most  especially  in  his  own  field,  for  his  pupils 
were  making  themselves  felt.  Of  all  the  surgeons  then 
active  in  London,  Astley  Cooper  was  becoming  the  most 
conspicuous,  and  there  were  also  his  old  master,  Cline,  and 
Abernethy,  Haighton,  and  Charles  Bell.  Cooper  was  the 
favorite  among  students.  His  infectious  enthusiasm,  his 
charm  of  person,  his  untiring  industry,  and  his  lucid, 
sparkling  lectures  attracted  crowds  of  young  men  to  him, 
while  his  genial,  democratic  manners  and  convictions 
made  him  the  choice  of  all  Americans.  John  C.  Warren 
had  recently  been  one  of  his  favorite  pupils,  and  Mott,  fol- 
lowing so  good  an  example,  turned  to  him  at  once  on  his 
arrival  in  London.  From  him  he  acquired  that  eager  ap- 
preciation of  and  fondness  for  applied  anatomy  which  dis- 
tinguished him  through  life.  All  of  those  conspicuous 
men  whom  we  have  named  were  physicians  as  well  as  sur- 
geons. It  was  true  of  them,  as  Gross  wrote  of  American 
surgeons  seventy  years  later,  "  There  were,  strange  to  say, 
as  a  separate  and  distinct  class,  no  such  persons  as  sur- 
geons among  us,  and  there  is  not  a  medical  man  on  this 
continent  who  devotes  himself  exclusively  to  the  practice 
of  surgery." 

Mott  passed  a  year  in  London  in  such  surroundings  and 
with  such  advantages.  Cooper  seems  to  have  thought  well 
of  him  and  to  have  made  much  of  him.  Twenty-five  years 
later,  when  they  were  both  getting  on  in  life,  the  two  men 


236  MEDICINE    IN   AMERICA. 

met  again  in  London,  when  the  old  surgeon  recognized  at 
once  his  sometime  pupil.  Mott  thought  very  highly  of 
Abernethy,  whose  fame  has  been  so  much  overshadowed 
by  that  of  the  better-known  Cooper,  and  he  was  wont  to 
say  of  him  that  if  Cooper  had  not  stood  by  his  side,  Aber- 
nethy would  have  been  looked  to  as  the  most  learned, 
scholarly,  able,  and  foremost  of  English  surgeons. 

Edinburgh  was  more  pleasant  to  Mott  than  was  Lon- 
don. Probably  in  the  smaller  town  the  kindly  Scots  paid 
more  regard  than  did  the  Londoners  to  the  able  and 
modest  young  gentleman  from  New  York.  Those  were 
great  years  in  Edinburgh;  the  very  names  of  the  men 
on  the  street  rendered  famous  to  us, — Scott,  Jeffrey,  Syd- 
ney Smith,  and  a  score  of  others.  We  all  know  the  famil- 
iar engraving  of  Scott  reading  aloud  to  his  friends.  One 
would  be  glad  to  know  if  Mott  knew  Sydney  Smith  well. 
It  was  that  shrewd  critic  who  asked  later,  in  the  Edin- 
burgh Review,  whether  any  one  had  ever  read  an  Ameri- 
can book ;  ^  when,  promptly,  all  America  went  to  work  to 
refute  the  sneer,  and  has  been  hard  at  it  ever  since. 

In  Edinburgh  the  teachers  were  such  as  McDowell  had 
known  fifteen  years  earlier,  Gregor}'  and  Monro  beingverv 
distinguished ;  and  there,  too,  John  Bell  was  to  be  found. 
That  was  a  remarkable  man.     Our  kindly  but  garrulous 


' "  The  Americans  are  a  brave,  industrious,  and  acute  people,  but 
they  have  hitherto  made  no  approaches  to  the  heroic,  either  in  their 
morality  or  their  character.  During  the  thirty  or  forty  years  of  their 
independence  they  have  done  absolutely  nothing  for  the  sciences, 
for  the  arts,  for  literature,  or  even  for  the  statesmanlike  studies  of 
politics  and  political  economy.  ...  In  the  four  quarters  of  the  globe, 
who  reads  an  American  book?  or  goes  to  an  American  play?  or 
looks  upon  an  American  picture  or  statue?  What  does  the  world 
yet  owe  to  American  physicians  or  surgeons?  What  new  substances 
have  their  chemists  discovered,  or  what  old  ones  have  they  ana- 
lyzed? What  new  constellations  have  been  discovered  by  the  tele- 
scopes of  Americans?  What  have  they  done  in  mathematics?  Who 
drinks  out  of  American  glasses,  or  cats  out  of  American  plates,  or 
wears  American  coats  or  gowns,  or  sleeps  in  American  blankets?" 


XIX.  CENTURY.     EARLY    SURGEONS.      237 

Gross  puts  him  on  a  "  lofty  eminence,  a  fit  resting-place 
for  an  eagle."  He  struggles  for  words  grand  enough  to 
describe  his  genius,  and  winds  up  by  placing  his  name  by 
the  side  of  that  of  Harvey.  John  Bell  certainly  was  an 
unusually  able  man,  a  skilful  surgeon,  and  a  delightful 
teacher.  Like  our  American  Physick,  he,  too,  was  a  father 
of  surgery, — Scotch  surgery  in  this  case. 

So  Mott  saw  Bell  at  work  as  he  had  seen  Cooper,  and  it 
was  a  goodly  sight  for  young  America.  He  spent  a  year 
or  more  at  such  tasks,  following  surgery  mainly;  and 
then,  in  1809,  returned  to  New  York  to  take  up  the  real 
labor  of  life. 

Mott's  professional  chances  were  brilliant  from  the  out- 
set of  his  practice.  He  had  a  solid  intelligence  and  was 
well  educated;  he  was  painstaking  and  thorough,  and 
had  absorbed  from  Astley  Cooper  that  great  man's  almost 
romantic  love  of  his  profession.  Besides,  there  were  va- 
rious adventitious  advantages.  He  was  handsome  and 
carried  himself  unconsciously  with  an  air  of  distinction. 
He  was  kindly,  patient,  accessible,  tactful,  and  modest. 
Such  characteristics  have  served  to  attract  and  to  hold 
patients  from  Fuller's  day  to  this.  Fortunately  for  him- 
self and  us,  Mott's  father  was  living  and  well  able  to 
assist  his  son  with  an  allowance,  so  that  the  young  man 
was  not  forced  to  give  himself  up  entirely  to  the  earning 
of  that  "  damned  guinea,"  as  John  Hunter  used  to  call  it, 
but  could  still  devote  much  time  to  study  and  to  anatomi- 
cal research.  His  first  method  of  making  himself  known 
to  the  profession  was  by  giving  an  admirable  course  of 
private  lectures  on  surgery,  and  so  striking  was  his  success 
that  the  next  year  he  was  made  a  lecturer  on  surgery  in 
the  Columbia  School. 

The  chaos  in  New  York  medical  teaching  was  approach- 
ing an  end  in  those  years.  Columbia  was  struggling 
along  when  the  College  of  Physicians  and  Surgeons  was 
established  in  1807  as  a  department  of  the  University  of 


238  MEDICINE    IN    AMERICA. 

New  York.  The  two  schools  remained  apart,  unfruitful 
and  ineffective,  for  four  years,  and  then,  in  181 1,  were 
united.  In  that  union  several  good  medical  names  were 
brought  to  the  front,  the  most  conspicuous  being  those  of 
Samuel  Bard,  Wright  Post,  William  Hammersley,  Samuel 
L.  Mitchell,  John  W.  Francis,  and  Valentine  Mott. 

So  Mott  was  transferred  to  the  new  School  and  there 
carried  on  the  work  so  well  begun.  He  was  a  most  stimu- 
lating teacher.  Had  he  done  nothing  else,  that  work 
would  have  made  him  noteworthy.  His  lectures  were 
continued  for  fifty-six  years  and  his  signature  is  affixed  to 
thousands  of  diplomas  scattered  through  the  land.  He 
made  no  display  or  trial  for  effect.  He  was  never  bom- 
bastic; but  he  was  full  of  his  subject,  he  had  an  immense 
deal  to  say,  and  he  said  it  with  conviction  and  enthusiasm. 
His  talks  were  carefully  planned,  but  were  not  written  out. 
nor  did  he  commit  to  memory.  He  dealt  largely  with 
fact,  little  with  theory,  and  illustrated  his  points  with 
abundant  anecdotes  drawn  from  his  own  great  experience. 
More  than  most  men  of  that  generation,  his  teaching  was 
clinical,  and  the  actual  patient  was  shown  to  give  point  to 
his  statements.  One  of  his  old  pupils  has  told  me  that  he 
can  never  forget  the  enthusiasm  for  anatomical  studies 
with  which  Mott  always  inspirerl  his  classes,  the  eagerness 
with  which  men  followed  his  lectures,  and  the  constant 
popularity  of  his  courses.  Though  a  pupil  himself  of  such 
great  masters  as  Cooper  and  Bell,  Mott  was  not  an  imita- 
tor, but  had  a  distinct  manner  of  his  own  and  was  quite  as 
successful  as  they.  He  loved  teaching,  which  is  the  vital 
thing  after  all ;  so  that,  besides  his  regular  College  classes, 
he  had  in  early  life  a  great  number  of  private  pupils.  He 
appreciated,  too,  the  importance  of  a  thorough  training 
and  a  knowledge  of  first  principles,  and  was  unwearied  in 
the  detail  of  instruction.  Late  in  life  he  instituted  three 
prize  medals  for  the  best  dissections  and  clinical  reports 
in  the  University  of  the  City  of  New  York,  and  he  left 


XIX.  CENTURY.     EARLY    SURGEONS.      239 

by  will  a  fund  to  perpetuate  those  prizes.  Such  anatomi- 
cal preparations  were  added  to  his  museum,  which  com- 
prised something  over  a  thousand  specimens;  but  nearly 
the  whole  collection  was  lost  in  the  burning  of  the  Med- 
ical College  the  year  after  his  death. 

Fortunately  or  unfortunately,  according  to  one's  view 
of  it,  Mott's  services  were  not  confined  to  one  school,  but 
were  given  to  a  considerable  number.  We  have  seen  how 
he  became  connected  with  the  College  of  Physicians  and 
Surgeons  in  181 1,  as  Professor  of  the  Principles  and 
Practice  of  Surgery,  Wright  Post  and  John  Augustine 
Smith  being  at  the  head  of  the  combined  departments  of 
Anatomy,  Physiology,  and  Surgery. 

In  1826  there  occurred  a  rebellion  of  the  whole  faculty. 
The  trustees  of  the  college  had  persisted  in  certain  courses 
which  were  regarded  as  tyrannical,  whereupon  the  teach- 
ing staff  withdrew  and  established  a  new  School  in  con- 
nection with  Rutgers  College,  of  New  Brunswick,  New 
Jersey.  It  was  a  strong  body  of  professional  men  and  the 
School  was  very  prosperous  for  five  years.  Certain  ille- 
galities of  its  charter,  touching  the  right  of  conferring  de- 
grees, were  discovered,  however,  and  it  was  obliged  to 
suspend.  After  this  Mott,  with  many  of  his  associates, 
returned  to  the  "  Physicians  and  Surgeons,"  his  own  de- 
partment now  being  the  professorship  of  Operative  Sur- 
gery with  Surgical  and  Pathological  Anatomy.  This  place 
he  held  until  1835,  when  he  resigned  on  account  of  ill 
health,  and  went  abroad  for  several  years.  In  1840,  when 
he  returned,  the  University  of  the  City  of  New  York  had 
recently  established  a  Medical  School,  and  Mott  was 
unanimously  elected  Professor  of  Surgery  and  President 
of  the  Medical  Faculty.  With  a  strong  staff,  which  in- 
cluded Pattison,  Revere,  Paine,  Draper,  and  Bedford,  the 
new  School  was  very  successful  and  useful.  Here  Mott 
worked  and  taught  until  1850,  when  he  resigned  and  again 
went  to  Europe.     On  his  return  the  same  year  he  was 


240  MEDICIXE    IX    AMERICA. 

made  Professor  of  Operative  Surgery  and  Surgical  Anat- 
omy in  the  College  of  Physicians  and  Surgeons.  Two 
years  later  he  resigned  this  chair  and  was  made  Emeritus 
Professor  of  Surgery  in  the  Universit}'-.  There  he  lec- 
tured annually  until  his  death  in  1865. 

Such,  ver}-  briefly,  is  the  synopsis  of  his  teaching  life, 
and  for  usefulness  and  value  that  life  may  be  divided  into 
two  parts  by  his  first  journey  to  Europe  and  the  East. — 
a  journey  which  occupied  nearly  five  years.  It  was  in  the 
years  before  that — before  1835 — that  he  made  his  name. 
In  those  early  twenty-six  years  he  was  at  his  best ;  during 
that  period  he  did  his  hardest  studying,  teaching,  and 
practising,  and  demonstrated  the  operations  which  made 
him  famous.  He  went  abroad  a  distinguished  man,  fifty 
years  of  age,  with  his  force  but  little  abated.  After  his 
return  he  buckled  on  the  harness  again,  kept  well  to  the 
front,  and  was  followed,  esteemed  and  revered, — a  potent 
and  stimulating  old  man, — to  the  end.  in  his  eightieth 
year;  but  he  had  ceased  to  make  histor\\  It  was  a  name 
that  long  overshadowed  all  others,  and  has  come  down 
with  a  well-defined,  little-dimmed  lustre  to  our  own  gen- 
eration; but  for  accomplishment  he  belongs  to  the  early 
days,  now  nearly  a  century  gone,  with  Warren  and 
Physick,  Xathan  Smith.  ^McDowell,  and  Dudley. 

In  dealing  with  those  men  the  perspective  is  not  always 
clear  and  their  achievements  not  always  obvious,  or  dwin- 
dling small,  perhaps,  by  comparison  with  what  we  now 
know  and  do ;  but  they  were  pioneers,  very  strong  in  their 
generation, — men  who  would  have  filled  space  even  in 
these  present  times,  and  without  them  we  could  scarce 
have  been. 

Mott  did  all  that  teaching  of  which  we  have  heard,  and 
more  than  any  other  American  then  living  he  impressed 
upon  surgeons  the  importance  of  anatomy  and  continual 
dissecting.  His  work  upon  the  blood-vessels  alone  was  so 
insistent  that  the  influence  still  persists.    With  us,  and  in 


XIX.  CENTURY.     EARLY    SURGEONS.      241 

civil  practive  especially,  the  ligature  of  arteries  is  infre- 
quent; but  we  all  patiently  study  their  relations  and,  be- 
cause Mott  so  taught,  spend  many  hours  yearly  teaching 
our  students  those  mysteries.  But  Mott's  studies  in  anat- 
omy covered  many  other  things,  and  he  dissected  far  more 
than  do  we  to-day.  Not  that  such  studies  are  less  impor- 
tant now  than  then,  but  because  we  keep  ourselves  re- 
freshed largely  by  operations  on  the  living.  In  those  days, 
before  ether  and  before  asepsis,  operations  were  infre- 
quent. No  man  was  a  surgeon  only,  for  there  was  little 
surgery  to  do.  The  man  among  us  who  does  his  three  or 
four  hundred  operations  annually  would  scarcely  have 
done  fifteen  or  twenty  a  hundred  years  ago;  so  that  the 
hand  became  unskilled  and  the  memory  rusted  without 
constant  resort  to  the  dissecting-room. 

Mott  became  prominent  as  a  practitioner  within  a  very 
few  years  after  his  establishment  in  1809,  and  in  general 
practice  he  was  earlier  successful  than  either  Cooper  or 
Physick  had  been.  The  influence  of  women  has  much  to 
do  with  the  popularity  of  a  budding  physician,  and  they 
admired  Mott  as  "  the  handsome  young  Quaker  doctor." 
This  influence  is  a  curious  thing.  Women  comprise  the 
majority  of  a  general  practitioner's  patients  because,  far 
more  than  men,  they  are  victims  of  minor  ailments  for 
which  they  seek  advice,  and  they  usually  select  the  man 
who  is  to  take  care  of  their  children.  For  these  reasons 
they  have  it  in  their  power  to  make  or  mar  a  beginner; 
their  doctor,  equally  with  their  children,  becomes  a  com- 
mon subject  of  gossip;  and  though  their  estimate  of  his 
professional  attainments  is  based  on  prejudice  or  fancy,  a 
man  must  possess  very  real  merit  indeed  to  escape  this 
subtle  influence  for  good  or  ill. 

Most  fortunately  for  Mott,  he  was  too  strong  a  man 
and  too  well-equipped  a  surgeon  to  be  affected  by  a  pass- 
ing popularity.  His  real  abilities  were  known  to  his  pro- 
fessional brethren,  and  he  became  a  valued  consultant  to 

16 


242  MEDICINE    IN   AMERICA. 

them  at  a  very  early  period.  The  one  thing  lacking  in  his 
first  years  was  a  hospital  appointment,  and  every  surgeon 
knows  how  serious  a  disadvantage  is  that  lack.  It  limits 
a  man's  work  to  his  own  and  to  his  consultants'  private 
patients,  and  it  cuts  him  off  from  all  the  great  and  selected 
pathological  material  which  the  wards  of  a  general  hos- 
pital alone  can  furnish.  In  other  words,  it  seriously  limits 
his  experiences  as  well  as  his  occasions  for  usefulness. 
Mott  had  been  eight  years  in  practice  before  he  gained 
the  coveted  prize,  when  in  1817,  he  was  appointed 
Attending  Surgeon  to  the  New  York  Hospital.  His 
associates  on  the  stafif  were  Wright  Post,  his  old  master, 
Richard  S.  Kissam,  and  Alexander  H.  Stevens. 

With  this  appointment  Mott's  opportunities  were 
greatly  increased,  his  operative  skill  was  seen  abun- 
dantly, and  at  the  Hospital  he  performed  the  operation 
which  caused  his  name  to  be  spoken  on  both  sides  of  the 
Atlantic, — the  ligature  of  the  innominate  artery.  He 
performed  the  operation  and  awoke  the  next  morning  to 
find  himself  famous.  Formidable  operations  are  now  of 
such  daily  occurrence  that  it  is  difficult  to  conceive  the 
furore  occasioned  by  Mott's  feat.  A  few  years  earlier 
Cooper  had  tied  the  abdominal  aorta,  but  even  that  had 
made  scarcely  more  talk. 

Mott  did  his  operation  in  May,  18 18,  the  year  after 
receiving  his  hospital  appointment.  The  innominate 
artery,  as  the  non-medical  reader  may  wish  to  know,  is 
a  large  blood-vessel,  an  inch  and  a  third  long,  which 
springs  from  the  right  side  of  the  arch  of  the  aorta,  close 
to  its  exit  from  the  heart,  and  runs  towards  the  right 
collar-bone.  It  divides  shortly  into  two  great  vessels 
which  carry  blood  to  the  right  arm  and  the  right  side  of 
the  neck  and  head.  In  Mott's  case  the  innominate  was 
tied  for  the  cure  of  aneurism,  or  great  distention  and  thin- 
ning of  the  arterial  branch  running  to  the  arm.  The 
patient  was  one  Michael  Bateman,  a  seaman  from  Massa- 


XIX.  CENTURY.     EARLY    SURGEONS.      243 

chusetts,  who  had  recently  been  admitted  to  the  New  York 
Hospital.  The  operation  had  never  before  been  done  on 
the  living.  We  must  remember  that  the  patient  was  not 
under  ether  and  that  the  surgeon  must  work  rapidly  and 
surely  among  some  of  the  most  important  structures  of 
the  body,  conscious  all  the  time  that  his  patient  is  in  ter- 
rible agony,  perfectly  aware  of  what  is  going  on.  At  the 
outset  Mott  intended  to  tie  the  branch  vessel,  but  found 
that  artery  so  diseased  that  he  abandoned  the  attempt  and, 
carrying  the  dissection  deep  into  the  chest,  threw  a  liga- 
ture about  the  innominate  itself.  Remember,  too,  that  by 
tying  this  he  also  cut  off  the  blood  running  to  the  right 
side  of  the  brain,  and  that  there  was  no  precedent  to  indi- 
cate what  the  immediate  result  to  life  might  be.  The  liga- 
ture was  tightened  very  slowly  indeed  and  then  tied, 
when,  to  his  intense  relief,  Mott  saw  that  no  appreciable 
damage  to  the  brain  and  nervous  system  resulted. 
Promptly  the  swollen  artery  was  reduced  to  one-third  its 
former  volume.  The  man  lived  twenty-five  days  and  then 
died  of  recurring  hemorrhages.  In  this  and  similar  opera- 
tions Mott  always  took  the  most  acute  interest,  but  it  was 
not  until  forty-six  years  later,  in  1864,  that  any  surgeon 
succeeded  in  saving  his  patient  after  ligature  of  the  in- 
nominate. That  first  successful  case  belongs  to  a  New 
Orleans  surgeon,  A.  W.  Smyth,  who-  tied  at  the  same  time 
the  carotid,  or  great  artery  of  the  neck,  thus  making  more 
certain  the  complete  checking  of  hemorrhage. 

But  Mott's  first  operation  made  him  famous,  and  it  is 
for  that  more  than  for  any  other  one  thing  that  he  is 
known  to-day  in  surgical  annals.  The  performance  was 
witnessed  by  many,  all  of  whom  testified  enthusiastically 
to  the  surgeon's  nerve,  resourcefulness,  and  skill. 

Mott's  amputation  at  the  hip-joint,  supposed  at  the  time 
(1824)  to  be  the  first  case  of  the  kind  in  America,^  was 


'  Brashear,  of  Kentucky,  had  done  the  operation  in  1806,  but  his 
case  had  not  been  published. 


244 


:\IEDICINE    IN    AMERICA. 


the  occasion  for  further  applause ;  and  e\'en  more  famous 
was  his  removal  of  the  entire  clavicle  for  a  very  extensive 
tumor  (osteosarcoma)  involving  many  important  neigh- 
boring structures.  He  called  it  his  \\^aterloo  operation 
because  it  vras  done  on  the  anniversary  of  that  battle.  The 
patient,  a  young  man  of  nineteen,  recovered  and  li\ed 
many  years,  with  a  useful  arm.  In  1827  Mott  tied,  for 
aneurism,  the  common  iliac  artery, — a  great  vessel,  which 
is  one  branch  of  the  Y  into  which  the  aorta  divides,  low 
in  the  abdomen, — and  the  patient  recovered  perfectly.  In- 
deed, for  his  work  on  the  blood-vessels  Mott  was  best 
known.  It  is  said  that  no  surgeon,  living  or  dead,  ever 
tied  so  many  arteries,  his  total  of  great  vessels  alone  being 
one  hundred  and  thirty-two,  including  eight  cases  of  the 
subclavian,  fifty-one  of  the  common  carotid,  six  of  the 
internal  iliac,  fifty-seven  of  the  femoral,  and  ten  of  the 
popliteal. 

That  successful  tying  of  the  common  iliac  was  the  sec- 
ond case  ever  so  operated  upon  and  Mott's  patient  was  the 
first  one  to  survive.  The  former  and  unsuccessful  case 
was  in  the  hands  of  another  brilliant  and  daring  Ameri- 
can surgeon,  William  Gibson,  of  Baltimore.  His  patient 
had  been  wounded  in  the  abdomen  by  a  gunshot.  Gibson 
tied  the  vessel  to  arrest  hemorrhage,  but  the  man  died  of 
peritonitis. 

Other  fields  in  which  ]\lott  did  good  work  were  the 
surgery  of  harelip,  excisions  of  the  jaws,  and  cutting 
for  stone  in  the  bladder.  Of  course,  as  time  went  on  and 
his  reputation  Ijecame  more  and  more  conspicuous,  he  was 
consulted  for  numberless  conditions  in  which  he  was  not 
especially  at  home,  but  he  seems  to  have  had  the  rare  self- 
restraint  to  refuse  cases  for  which  he  did  not  regard  him- 
self an  expert.  Another  pleasant  quality  of  his  younger 
days  was  a  frank  modesty  in  regard  to  the  work  of  other 
surgeons.  If  a  colleague  proved  himself  successful  in 
some  particular  operation  which  Mott  did  inefficiently  or 


XIX.  CENTURY.     EARLY    SURGEONS.      245 

not  at  all,  he  did  not  assume  the  attitude  that  that  opera- 
tion was  insignificant  or  useless,  but  frankly  admitted  that 
the  other  surgeon  was  the  better  man  at  that  particular 
piece  of  work.  He  was  much  like  the  rest  of  mankind  in 
many  ways,  but  was  willing  to  grant  that  there  was  room 
for  more  than  one  surgeon  in  New  York  City. 

Again,  in  thinking  of  those  men  and  their  times  one 
must  stop  to  reflect  how  small  a  community  America  then 
was.  When  Mott  began  practice  the  whole  country  con- 
tained but  one-sixth  of  its  present  population,  and  New 
York  was  a  delightful  old-fashioned  town,  not  differing 
much  from  the  colonial  type,  with  quiet  streets,  retired 
squares,  dignified  home-like  houses,  and  pleasant  farms 
within  easy  drive.  It  was  smaller  than  Philadelphia  and 
but  little  larger  than  Boston.  Every  one  knew  every  one 
else.  The  life  was  quaint,  kindly,  and  agreeable.  The 
Hudson  River  was  still  the  main  thoroughfare  up  the 
State,  and  civilization  had  scarcely  penetrated  beyond  the 
Falls  of  the  Genesee.  Newspapers  were  few,  and  there 
was  but  one  considerable  medical  periodical.  It  was  a 
small  and  scattered  audience  to  which  men  talked.  But 
the  great  expansion  of  the  country  was  well  begun,  and 
more  and  more  messages  of  the  wise  were  being  carried 
to  the  struggling  pioneers. 

Many  men  are  living  to-day  who  can  recall  the  sort  of 
frontier  doctors  we  had  in  the  first  half  of  the  nineteenth 
century :  their  rough,  forceful  ways,  their  ingenuity,  and 
their  fearlessness.  Many  of  them  had  gone  to  the  cities 
for  their  training,  many  had  come  out  from  the  East,  and 
they  carried  with  them  into  their  wild  communities  a  re- 
flection, at  least,  of  what  was  doing  in  the  larger  world. 
Now,  it  was  for  such  doctors  as  these,  among  others,  that 
Mott  labored.  He  had  a  large  idea  of  the  country's 
future,  a  thorough  appreciation  of  the  meaning  of  a  scien- 
tific training,  and  early  he  conceived  an  ambition  to  have 
the  medical  work  of  the  next  generation  done  by  properly 


246  MEDICINE    IN   AMERICA. 

qualified  men.  According  to  the  needs  of  the  hour,  he  in 
some  sort  succeeded.  He  and  his  colleagues  did  manage 
to  train  in  a  rough  fashion  men  competent  to  do  their  share 
in  the  life  before  them  and  to  act  worthily  as  the  leaders 
towards  a  higher  civilization.  In  a  hard-working  fron- 
tier existence  the  actual  and  the  practical  are  what  are 
wanted  of  medicine.  There  is  little  need  of  the  refine- 
ments of  diagnosis  and  the  subtile  suggestions  of  a  phan- 
tom therapeutics.  Your  leg  is  broken  or  it  isn't ;  you  have 
pneumonia  or  you  haven't,  and  there  is  an  end  of  the  mat- 
ter. Very  practical  and  very  sane  all  that — if  only  later 
days  might  so  endure. 

In  1835  Mott  found  himself  seriously  broken  in  health; 
so  he  went  to  Europe  and  was  lionized.  Then  he  came 
home  and  wrote  about  it  and  was  laughed  at  by  some.  He 
had  been  sent  off  with  a  great  blare  of  trumpets.  His 
associates,  with  good  old  Hosack  as  their  chairman,  gave 
him  a  public  dinner  and  made  much  of  him  in  the  way 
so  characteristic  of  serious  professional  men.  He  sailed 
with  all  their  kind  sayings  and  good  wishes  in  his  ears, 
and  he  was  welcomed  in  London  and  Paris  by  men  almost 
equally  appreciative.  No  sooner  was  he  landed  in  Eng- 
land than  he  hurried  to  meet  his  old  master,  Astley  Cooper, 
then  in  his  sixty-ninth  year.  He  was  recognized  even  be- 
fore announcing  himself,  and  was  received  with  a  cour- 
teous enthusiasm  which  never  forgot  the  fame  the  Ameri- 
can had  acquired  since  the  early  London  days. 

Since  the  time  of  Mott's  youth,  however,  the  centre  of 
medical  interest  had  shifted  from  London  to  Paris,  and 
to  Paris  he  went  eagerly.  Old  Larrey,  Napoleon's  great 
surgeon,  was  still  living  there, — a  man  never  to  be  for- 
gotten by  his  guild.  This  ancient  personage  was  Sur- 
geon-in-Chief  to  the  Invalides  at  the  time  of  Mott's  visit, 
and  was  untiring  in  his  courtesies  and  attentions  to  the 
visitor.  Mott  spent  several  weeks  in  Paris  as  in  London, 
visiting  the  hospitals  and   enjoying  his   social   honors. 


XIX.  CENTURY.     EARLY    SURGEONS.      247 

Among  the  men  specially  mentioned  in  his  journal  were 
Guerin,  Civiale,  and  Velpeau.  Then  he  went  to  Berlin, 
and  was  received  by  Dieffenbach,  and  so  continued 
through  Germany,  Belgium,  Switzerland,  Italy,  Greece, 
Egypt,  and  Turkey.  His  account  of  his  travels  is  en- 
tertaining. He  interrupted  them  during  the  second  year 
by  returning  to  New  York,  but  soon  went  back  again, 
and  remained  abroad  about  five  years  in  all.  While  in 
Greece  he  made  Athens  his  head-quarters  for  a  long  visit, 
and  journeyed  about  the  country  with  great  enthusiasm, 
trying  to  reconstruct  the  classic  scenes  and  times  and 
men  as  Henry  Holland  had  done  before  him  and  as  so 
many  moderns  have  done  before  and  since.  In  the  mod- 
erns of  Greece  he  was  wofully  disappointed.  As  he  mildly 
remarks,  "  they  seem  tO'  be  sunk  toO'  low  in  all  the  vices 
of  Oriental  indolence  ever  to  be  regenerated."  His  jour- 
ney to  ancient  Epidaurus,  the  birthplace  of  ^sculapius, 
was  a  cause  of  much  mirth  at  his  expense.  He  went  there 
bearing  a  cock,  which  he  sacrificed  to  the  memory  of  the 
ruling  deity,  having  first  tied  both  carotid  arteries  of  the 
bird,  and  delivered  a  brief  clinical  lecture  to  his  com- 
panions. His  biographer  chides  the  medical  press  for 
making  fun  of  the  delicious  situation.  From  Athens 
Mott  went  to  Constantinople,  where  he  took  a  wen  out 
of  the  Sultan's  head  while  the  trembling  court  physician 
applauded.  The  Sultan  made  him  a  Knight  of  Medji- 
dichi,  and  then  he  came  home  to  New  York,  where  those 
stories  of  the  cock's  carotids  and  his  Medjidichian  honors 
had  preceded  him. 

That  ends  the  story  of  Mott's  life  so  far  as  his  best  work 
is  concerned.  He  lived  twenty-five  years  after  coming 
back  to  us,  and  the  years  were  useful  ones.  As  a  teacher 
and  operator  and  as  an  agreeable  man  he  continued  to  im- 
press the  rising  generation,  and  he  lived  through  the  Civil 
War.  He  went  again  to  Europe  later,  but  brought  back 
no  more  titles.  The  tale  glides  quietly  along,  not  greatly 
salient. 


248  MEDICINE    IN   AMERICA. 

We  cannot  but  regret  that  Mott  was  no  writer;  he 
hated  the  drudgery  of  putting  down  words.  There  came 
from  him  many  chnical  reports,  of  course,  but  no  magnum 
opus.  In  1818  he  helped  found  the  "  New  York  Medical 
and  Surgical  Register,"  but  the  work  ceased  when  one 
volume  had  been  published.  He  did  publish  his  "  Travels 
in  Europe  and  the  East," — a  considerable  octavo, — and 
we  know  how  the  reviewers  made  unkind  remarks  on  that. 

I  think  his  best  printed  writings,  and  the  ones  which 
now  attract  us  most,  were  his  introductory  lectures  to  his 
classes  and  to  societies,  and  his  eulogies  of  Wright  Post 
and  John  W.  Francis.  When  all  is  said,  however,  there 
was  little  enough.  Where  he  failed  many  lesser  men  have 
succeeded.  He  did  not  give  forth  to  the  world  the  best 
that  was  in  him.  He  will  be  remembered  because  medical 
history  must  take  note  of  that  innominate  which  he  tied; 
but  his  great  learning,  his  operative  abilities,  his  genius 
for  teaching, — those  things  have  perished  with  him.  Had 
he  been  so  minded,  he  might  have  enrolled  himself  in  med- 
ical literature  by  the  side  of  Cooper  and  Brodie  and  Paget. 
But  he  failed  to  impress  men  beyond  the  circle  of  his  own 
life,  to  the  end  that  he  was  himself  the  loser,  and  we  to-day 
lack  fruitful  records  of  one  of  the  strongest  men  in  Ameri- 
can surgery. 

Unlike  the  history  of  literature  or  of  politics,  the  his- 
tory of  medicine  must  be  largely  an  account  of  men  and 
the  lives  they  led.  Good  literature  produced  in  the  eigh- 
teenth century  is  good  literature  in  the  twentieth  century. 
The  political  acts  and  motives  of  our  ancestors  find  their 
counterpart  among  us  to-day  and  the  value  of  such  things 
is  vital  still ;  but  the  science  of  ancient  times  is  no  longer 
our  science.  With  few  exceptions,  that  old  knowledge  is 
but  as  the  babbling  of  children.  We  cannot  take  seriously 
most  of  the  former  wisdom,  but  we  may  honor  the  men 
and  follow  their  lives  and  admit  the  debt  we  owe  them; 
for  out  of  their  much  talking  and  blind  gropings  there 


XIX.  CENTURY.     EARLY    SURGEONS.      249 

grew  the  scaffolding  of  the  edifice  which  we  are  now 
building. 

When  we  come  down  to  the  men  of  our  grandfathers' 
generation  these  thoughts  are  not  so  obvious,  because  in 
those  men  we  begin  to  see  ideas  and  motives  and  acts  more 
modern.  But  much  that  they  did  well  now  seems  very 
feeble  and  erring, — little  worthy  of  serious  study,  though 
doubtless  very  important  and  urgent  a  hundred  years  ago. 

However,  the  reading  of  that  old  medical  literature  is 
still  very  interesting.  The  acumen  of  the  men,  with  the 
dim  light  they  had,  is  remarkable  indeed;  their  shrewd 
guessing,  their  frequent  missing,  and  their  infrequent  hit- 
ting of  the  mark  make  a  pursuit  of  constant  pleasure  and 
charm  for  the  student  of  those  times.  Yet  an  account  of 
such  hittings  and  missings  and  guessings  must  form  no 
part  of  this  work ;  the  task  would  be  too  intricate  and  lead 
us  into  technicalities  too  far  afield.  After  all,  it  is  the  men 
themselves  whom  we  must  observe,  together  with  those 
few  things  which  now  and  again  they  did  greatly. 

Among  the  men  of  that  generation  few  led  more  stead- 
ily laborious  and  useful  lives  than  John  Collins  Warren. 
He  was  seven  years  older  than  our  New  York  Mott,  being 
born  in  Boston  on  August  i,  1778,  and  was  the  eldest  son 
of  that  vigorous  and  interesting  John  Warren  ^  who 
served  in  the  Revolution  and  founded  the  Harvard  Med- 
ical School. 

If  ever  there  was  a  man  blessed,  or  cursed,  as  you 
choose,  with  the  New  England  conscience,  it  was  John 
Collins  Warren.  His  father  wanted  to  keep  him  out  of 
medicine,  and  he  himself  had  no  natural  liking  for  it.  We 
have  it  over  his  own  signature  that  he  was  indolent  and 
hated  study;  yet,  once  having  put  his  hand  to  the  plough, 


*  The  four  generations  of  surgeons  of  this  well-known  family  are : 
John  Warren,  1753-1815;  John  Collins  Warren,  1778-1856;  Jona- 
than Mason  Warren,  1811-1867;  and  John  Collins  Warren,  1842,  who 
is  still  active  among  us. 


250  MEDICINE    IN   AMERICA. 

he  never  turned  back,  but  devoted  himself  heart  and  soul, 
steadily,  faithfully,  without  enthusiasm,  to  his  profession 
for  more  than  fifty  years.  And  he  certainly  exercised  a 
very  marked  influence  upon  general  practice  in  Boston, 
upon  teaching  at  Harvard,  upon  surgery  at  the  Massa- 
chusetts General  Hospital,  and  upon  his  professional 
brethren  in  this  country.  Intellectually  he  was  unlike  any 
of  those  other  early  surgeons,  though  in  certain  elements 
of  training  and  experience  he  might  be  compared  to  Val- 
entine Mott.  Like  Mott,  he  was  the  son  of  a  doctor;  he 
was  born  and  reared  in  an  old,  well-established  com- 
munity and  in  a  medical  atmosphere;  he  was  thoroughly 
educated  for  his  work ;  and  he  spent  his  life  in  the  midst 
of  congenial  surroundings,  social  and  professional. 

We  probably  know  as  much  about  him  as  we  could 
know  about  any  man  of  his  temperament,  for  he  had  a 
steady  appreciation  of  his  position  in  life  and  took  copious 
biographical  notes  of  his  own  career.  Those  notes  were 
elaborately  edited  by  his  brother  soon  after  his  death. 

Inheriting  a  strong  position  from  his  distinguished 
father,  he  had  a  constant  and  proper  pride  in  supporting 
it;  and  the  combination  of  a  sound  understanding,  wide 
culture,  laborious  industry,  and  eager  grasp  of  opportu- 
nity, together  with  the  fortunate  circumstance  that  for 
many  years  he  met  with  little  serious  professional  compe- 
tition, secured  for  him  in  early  life  the  unique  position  of 
surgical  autocrat  of  New  England. 

His  biographical  notes  contain  abundant  material  for  a 
delightful  memoir  of  his  times,  if  only  they  had  fallen  into 
the  hands  of  a  Trevelyan  or  a  Lang.  Unfortunately,  his 
editor  was  too  much  bent  on  eulogy  for  the  popular  suc- 
cess of  the  book.  In  spite  of  these  drawbacks,  we  have  a 
picture  of  a  very  important  and  very  full  career,  and  of  a 
man  familiar  in  his  day  to  doctors  throughout  the  land. 

Warren's  youth  was  passed  amid  surroundings  which 
seem  very  ancient  to  us  now.    His  grandson  and  namesake 


XIX.  CENTURY.     EARLY    SURGEONS.      251 

has  given  us  a  charming  sketch  ^  of  those  old  days,  taking 
his  material  from  his  ancestor's  own  notes,  which  run, — 

"  At  the  period  when  I  left  college  and  became  an  inhab- 
itant of  Boston  it  was  thought  necessary  to  undergo  the 
operation  of  a  barber  half  an  hour  every  day.  This  con- 
sumed much  time,  besides  the  horrid  consequences  of  car- 
rying on  one's  head  a  quantity  of  curls,  flour,  pomatum, 
and  the  long  cue  or  heavy  club. 

"  The  dress  at  that  time  was  a  colored  coat  with  metal 
buttons,  usually  yellow ;  colored  waistcoat,  short  breeches, 
buttoning  at  the  knees;  long  boots  with  white  tops,  and 
when  riding  on  horseback  a  pair  of  leather  breeches  instead 
of  pantaloons,  of  drab  cloth. 

"  These  yellow  breeches  were  daily  cleaned  with  yellow 
clay,  which  required  that  the  coats  should  never  be 
brought  in  contact  with  them.  Then  a  short  ruffle  at  the 
breast  and  about  the  wrists,  a  white  cravat,  filled  out  with 
what  was  called  a  pudding,  the  use  of  which,  from  the 
effect  of  habit,  could  not  be  dispensed  with  for  some  years, 

"  Cocked  hats  were  very  much  worn  at  the  time,  but  not 
by  the  young. 

"  Gentlemen  of  a  certain  age  wore  wigs,  which  were 
sent  to  the  barbers  once  a  week  to  be  fresh  dressed,  so 
that  on  Saturday  night  we  saw  the  barbers'  boys  carrying 
home  immense  bundles  of  wig-boxes  as  a  preparation  for 
going  to  church  on  Sunday. 

"  Physicians  who  had  much  business  in  those  days  rode 
on  horseback.  Riding  in  a  chaise  was  very  rare,  and  in  a 
four-wheeled  carriage  still  more  so.  My  father  rode  on 
horseback  till  a  few  years  before  his  death. 

"  Dr.  Lloyd  generally  drove  a  very  fine  horse,  and  Drs. 
Jarvis  and  Whipple  were  famous  for  beautiful  saddle 
horses  and  the  elegance  with  which  they  rode. 

°  Reminiscences  of  an  Old  New  England  Surgeon  (Maryland  Med- 
ical Journal,  1901,  vol.  xliv.  p.  45),  by  J.  Collins  Warren,  M.D., 
F.R.C.S. 


252  MEDICINE    IN   AMERICA. 

"  Large  parties  opened  at  seven  or  eight  o'clock  in  the 
evening,  and  were  much  more  formal  than  at  present.  A 
friend  of  mine  told  me  that  he  saw  me  dance  a  minuet  in 
1786  or  thereabouts,  and  that  this  was  the  last  time  he  had 
witnessed  this  dance  in  Boston. 

"  Persons  of  a  certain  age  were  treated  with  a  degree  of 
deference  now  wholly  disused.  In  fact,  one  of  the  great 
traits  of  the  manners  of  the  present  time  is  the  manner  in 
which  young  persons  are  accustomed  to  treat  persons  older 
than  themselves. 

"  Gentlemen's  dinner  parties  began  early  and  ended  late. 
The  great  care  on  the  part  of  the  host  was  to  present  to 
the  guests  as  much  ordinary  wine  as  they  could  be  made 
to  drink,  and  then  to  bring  forward  in  succession  a  variety 
of  old  wines,  each  having  a  character  a  little  better  than 
that  which  preceded.  All  of  these  had  some  remarkable 
history  connected  with  them,  the  detail  of  which  consti- 
tuted an  important  part  of  social  discussion. 

"  On  the  whole,  the  dinner  parties  of  those  days  must 
be  looked  on  with  disgust,  for  not  only  was  the  quantity 
sufficient  to  make  irreparable  inroads  on  the  physical  or- 
ganization, but  this  indulgence  led  to  coarse  extravagance 
of  language  and  thought,  and  the  conversation  at  a  din- 
ner party,  if  taken  down  by  a  stenographer  and  presented 
to  the  party  on  the  morning  following,  would  have  filled 
them  with  shame  and  regret." 

Warren  was  intended  by  his  father  for  a  mercantile  life, 
but  a  suitable  opening  not  immediately  presenting  itself 
after  he  left  college,  he  passed  a  couple  of  years  at  French 
and  the  pretended  study  of  medicine,  as  he  himself  says. 
Then  he  went  to  Europe  and  settled  down  to  serious  work ; 
that  was  in  1799.  His  course  there  was  much  like  that  of 
many  other  young  American  students  whom  we  have  fol- 
lowed. London  claimed  him  first,  where  he  became  a 
pupil  of  William  Cooper,  and  later  of  William  Cooper's 
nephew,  Astley  Cooper.    The  elder  was  an  able,  conserva- 


XIX.  CENTURY.     EARLY    SURGEONS.      253 

tive  surgeon,  testy,  and  ignorant  of  all  things  beyond  his 
little  island,  and  was  the  antipodes  of  his  brilliant,  gen- 
erous, popular  nephew.  Warren  secured  a  dresser's  posi- 
tion at  Guy's  Hospital, — it  was  merely  a  matter  of  money 
down, — and  served  at  such  work  and  dissecting  for  some- 
thing more  than  a  year.  Then  he  went  to  Edinburgh  for 
a  year,  where  he  received  his  medical  degree,  and  then  for 
a  final  year  to  Paris.  In  the  two  latter  places  he  studied 
hard,  taking  up  chemistry,  general  medicine,  and  mid- 
wifery, as  well  as  anatomy  and  surgery.  He  lived  in  Paris 
with  Dubois,  Napoleon's  distinguished  surgeon,  and  stud- 
ied chemistry  with  Vauquelin  and  Fourcrois;  anatomy 
with  Ribes,  Sabatier,  Chaussier,  Cuvier,  and  Dupuytren; 
medicine  with  Corvisart;  and  botany  with  Desfontaines. 
That  was  a  brilliant  gathering  for  the  edifying  of  a  young 
gentleman  from  Boston.  He  says  that  the  French  stu- 
dents were  green  from  the  Revolution,  for  the  most  part 
a  rude  and  vulgar  set  of  people,  who  made  him  much 
trouble  first  and  last. 

In  the  autumn  of  1802  Warren  came  home  by  the  way 
of  England,  and  on  arriving  in  Boston  found  his  father  in 
very  poor  health.  In  order  to  relieve  him  he  immediately 
assumed  a  great  part  of  his  practice.  It  is  said  that  at 
this  time  the  elder  Warren  had  a  larger  private  practice  in 
Boston  than  any  other  physician  has  carried  before  or 
since.  At  any  rate,  the  son  found  himself  almost  swamped 
by  these  new  duties,  and  tells  in  his  Diary  that  frequently 
during  the  next  year  he  would  make  fifty  professional 
visits  a  day.  Allowing  for  a  working  day  of  sixteen  hours, 
this  would  give  him  about  twenty  minutes  to  each  patient, 
not  counting  the  time  consumed  in  travelling;  and,  as 
much  of  his  work  was  midwifery,  we  must  think  of  him 
as  a  young  man  with  an  extraordinary  burden  to  bear. 
It  is  recorded  of  both  the  Warrens  that  they  acquired  a 
very  great  facility  in  dealing  with  patients  and  a  remark- 
ably intuitive  skill  in  the  diagnosis  of  the  day.    Their  visits 


254  MEDICINE    IN    AMERICA. 

were  purely  business-like.  They  would  take  up  the  case 
at  once,  wasting  no  time  in  gossip,  and,  the  required  duty 
being  completed,  would  promptly  withdraw.  This  very 
sensible  method,  so  unlike  that  usually  followed  by  their 
colleagues,  gained  them  the  respect  of  their  patients  and 
daily  saved  hours  of  valuable  time. 

The  fortunate  young  Warren  found  other  advantages 
to  his  hand,  not  the  least  among  them  being  an  opportu- 
nity for  teaching.  His  father  was  finding  that  work  and 
the  ride  to  distant  Cambridge  almost  more  than  he  could 
bear,  so  the  son  was  set  to  work  to  relieve  him.  The  Har- 
vard School  was  still  in  its  infancy.  Its  distance  from 
Boston  made  it  difficult  of  access  for  students  living  in  the 
city,  and  there  was,  of  course,  an  absolute  lack  of  clinical 
material  in  Cambridge.  At  about  the  time  of  Warren's 
coming  home  James  Jackson  also  appeared  upon  the  scene, 
and  we  find  the  names  of  the  two  men  constantly  asso- 
ciated thereafter  for  more  than  fifty  years.  They  and 
their  contemporaries  were  joined  by  the  elder  Warren  and 
by  Dexter  in  the  effort  to  transfer  the  school  to  Boston, 
and,  after  years  of  rather  bitter  conflict  with  Waterhouse, 
they  succeeded  in  effecting  the  change  in  1810. 

Those  years  between  1802  and  1810  were  important 
ones  to  Warren  in  many  ways.  To  begin  with,  in  1803 
he  married  a  daughter  of  Jonathan  Mason,  and  began  the 
rearing  of  his  many  children.  He  was  active  in  all  sorts 
of  literary,  social,  and  scientific  enterprises.  With  John 
Lowell,  John  Quincy  Adams,  Kirkland,  Quincy,  Jackson, 
William  Emerson,  and  others  he  started  a  Natural  Phi- 
losophy Society;  with  Gardner,  Emerson,  W.  S.  Shaw, 
Buckminster,  Tuckerman,  Jackson,  and  others  he  estab- 
lished that  Anthology  periodical  and  the  Society  which 
grew  into  the  Boston  Athenaeum ;  with  Jackson,  Dixwell, 
Coffin,  Bullard,  and  Howard  he  formed  a  society  for  med- 
ical improvement.  In  1806  he  was  made  Adjunct  to  his 
father  in  the  chair  of  Anatomy  and  Surgery  at  Harvard, 


XIX.  CENTURY.     EARLY    SURGEONS.      255 

and  he  succeeded  to  the  full  professorship  upon  his  father's 
death,  in  181 5. 

Warren's  name  will  always  be  associated  with  two  im- 
portant facts.  One  was  the  founding  of  the  Massachusetts 
General  Hospital,  the  other  w^as  the  introduction  of  ether 
anaesthesia.  These  two  events  were  separated  by  an  inter- 
val of  twenty-five  years,  but  around  them  both  are  grouped 
nearly  all  that  is  conspicuous  in  Boston  medicine  during 
the  first  fifty  years  of  the  last  century.  There  were,  of 
course,  other  men  concerned  with  both  events,  some  of 
them  more  intimately  than  was  Warren;  but  Warren 
was  part  of  both,  and  for  such  distinction  is  known  to  us. 

Before  the  establishment  of  the  Hospital  his  constant 
occupation  as  a  teacher  and  general  practitioner  led  him 
into  lines  of  research  less  strictly  surgical  than  what  we 
know  of  his  work  in  his  later  years.  In  1809,  while  still 
comparatively  fresh  from  his  European  teachers,  he  pub- 
lished a  valuable  paper  on  organic  diseases  of  the  heart, 
a  subject  which  until  then  was  little  understood  in  this 
country;  and  in  181 1,  together  with  Jackson,  Gorham, 
Jacob  Bigelow,  and  Channing,  he  assisted  in  founding 
the  New  England  Journal  of  Medicine  and  Surgery.  This 
publication  was  ably  edited,  and  in  1828  was  united  with 
another,  under  the  title  Boston  Medical  and  Surgical  Jour- 
nal, which  flourishes  to-day. 

As  a  writer  Warren  was  clear  and  strong.  His  belief 
was  that,  as  yet,  the  profession  in  America  was  too  young 
and  inexperienced  for  original  work  of  moment.  He  rec- 
ognized the  inadequate  training  of  the  great  mass  of  his 
fellows,  and  he  was  convinced  that  their  first  need  was  to 
acquire  and  absorb  the  learning  of  the  Old  World.  This 
belief  he  preached  with  pen  and  by  word  of  mouth.  He 
was  one  of  the  first  to  see  the  true  functions  of  a  medical 
school,  and  he  followed  other  wise  men  in  insisting  upon 
the  establishment  of  hospitals.  His  lectures  were  care- 
fully prepared  and  systematically  delivered.    He  was  clear 


256  MEDICINE    IN    AMERICA. 

and  instructive  without  being  eloquent.  He  lacked  the 
charm  and  magnetism  of  his  father  and  uncle  in  public 
speaking,  but  was  more  learned  than  they,  and  ably  car- 
ried on  the  work  which  the  former  had  so  well  begun. 

The  Massachusetts  General  Hospital  was  slow  in  get- 
ting started.  So  long  ago  as  18 10  Jackson  and  Warren 
organized  the  movement  for  its  foundation, — a  movement 
which  had  been  in  contemplation  for  many  years;  if,  in- 
deed, it  may  not  be  regarded  as  the  direct  outgrowth  of 
that  great  military  hospital  over  which  old  John  Warren 
went  to  preside  in  1777.  When  that  old  institution  dis- 
appeared after  the  war,  the  elder  Warren  missed  it  sadly, 
and  in  his  later  life  essayed  to  promote  a  proper  substi- 
tute. 

At  last,  on  August  10,  1810,  these  various  desires  of 
wise  men  in  Boston  found  voice  in  a  circular  letter  signed 
by  James  Jackson  and  John  C.  Warren,  in  which  they 
asked  their  fellow-townsmen  for  subscriptions  to  a  "  hos- 
pital for  the  reception  of  lunatics  and  other  sick  persons." 
Promptly  the  good  work  was  taken  up  by  prominent  men 
of  the  laity, — James  Bowdoin  and  fifty-five  others,  citi- 
zens of  Massachusetts,  —  incorporators  under  the  title 
"  The  Massachusetts  General  Hospital,"  and  the  enter- 
prise progressed  slowly  and  substantially  until,  finally,  in 
September,  1821,  the  first  patient  was  received.  Warren 
was  then  forty-three  years  old,  and  his  father  had  been 
six  years  dead,  without  seeing  the  long-desired  hospital 
an  accomplished  fact. 

It  was  to  the  two  men,  Jackson  and  Warren,  that  we 
owe  the  Massachusetts  General  Hospital,  and  to  this  day 
their  names  and  that  of  Bigelow  are  the  ones  most  closely 
associated  with  it.  From  the  outset  it  was  a  general  hos- 
pital where  acute  diseases  of  all  kinds  were  received, 
though  from  the  beginning  its  wards  for  the  insane  were 
removed  to  a  distance — located  in  Somerville — and  named 
after  John  McLean,  who  had  contributed  towards  the 


XIX.  CENTURY.     EARLY    SURGEONS.      257 

foundation  sums  amounting  to  about  one  hundred  and 
twenty  thousand  dollars. 

Until  the  establishment  of  the  General  Hospital  there 
had  been  little  opportunity  in  Boston  for  study  and  ex- 
perimentation on  surgical  lines,  but  with  its  advent  War- 
ren's career  expanded  in  a  fashion  unknown  even  to  his 
father,  and  in  his  own  careful,  methodical,  and  pains- 
taking manner  he  proceeded  to  organize  a  routine  for  the 
surgical  staff,  after  a  fashion  which,  even  to  this  day, 
has  left  its  impress  upon  the  practice  of  Boston.  Warren 
was  very  able,  but,  unlike  many  other  able  men,  he  was 
a  man  of  detail.  His  whole  life  seems  to  have  been 
schematic,  and  his  hospital  practice  was  made  to  corre- 
spond with  the  rest  of  his  life.  We  have  seen  that  he 
was  keenly  alive  to  his  own  dignity  and  position,  and 
this  characteristic,  which  sometimes  became  irritating  to 
his  equals  in  the  outside  world,  was  made  to  serve  a  very 
useful  purpose  within  the  Hospital  walls. 

From  the  outset  his  department  was  conducted  on  lines 
of  almost  military  discipline.  His  colleagues  were  for- 
mally addressed  and  consulted,  and  the  nicest  punctilio 
was  observed  between  them.  His  juniors  on  the  staff 
were  required  to  hold  towards  him  and  the  other  senior 
surgeons  a  proper  distance  and  respect;  the  house  staff, 
as  we  should  call  the  young  graduates  who  act  as  assist- 
ants, were  enrolled  as  "  house  pupils,"  w^ere  addressed  as 
"  Mister,"  and  were  not  permitted  to  assume  the  title  of 
their  doctor's  degree  until  the  end  of  their  year  of  service. 
Their  duties  were  strictly  those  of  the  humblest  of  assist- 
ants, they  were  given  no  responsibility  beyond  the  very 
slightest,  and  their  labors  largely  consisted  in  the  careful 
waiting,  at  dictation,  of  voluminous  records  and  in  aiding 
in  the  dressing  of  wounds.  To  some  extent,  too,  they 
assisted  at  operations,  though  more  often  this  work  was 
done  by  one  of  the  surgeon's  own  colleagues.  In  their 
turn,  the  nurses  and  the  servants  of  the  Hospital  were 

17 


258  MEDICINE    IN   AMERICA. 

relegated  to  the  very  humblest  of  positions.  The  result 
of  all  this  was  a  most  admirable  machine  which,  once 
established,  ran  of  itself,  and  in  some  measure  still  runs 
on  much  as  it  was  set  going  eighty  years  ago. 

The  position  of  a  great  surgical  teacher  who  is  also  at 
the  head  of  a  hospital,  on  whom  students  wait  for  their 
instruction  and  young  doctors  for  their  orders,  is  almost 
unique  in  civil  life.  The  college  president  or  the  great 
merchant  is  less  of  an  autocrat  in  his  own  field.  The 
colonel  of  a  regiment  or  the  captain  of  a  man-of-war 
alone  surpasses  him;  and  we  must  believe  that  Warren, 
with  his  temperament  and  opportunities,  developed  to 
the  full  the  possibilities  of  the  situation. 

He  was  a  very  able  surgeon  of  the  painstaking  type. 
In  those  days  all  operations,  even  the  most  inconsiderable 
from  our  point  of  view,  were  serious  matters.  Without 
antiseptics  there  was  always  the  probability  of  serious  in- 
flammation following,  and  without  ether  there  was  always 
intolerable  pain ;  so  the  knife  was  used  sparingly  and  of 
dire  necessity  only,  and  he  was  thought  the  most  skilful 
surgeon  who  could  avoid  it  longest.  Warren  prepared 
with  the  greatest  care  for  each  operation.  He  read  up  his 
authorities,  he  consulted  his  notes,  he  studied  his  case,  and 
he  practised  on  the  dead  subject.  By  such  practice  he  be- 
came rarely  facile,  but  never  presumed  on  his  facility.  His 
work  on  the  living  was  done  methodically  and  with  minute 
pains,  to  avoid  hemorrhage  or  damage  to  structure,  and  it 
was  thoroughly  done.  In  all  the  minutiae  of  dressings, 
bandaging,  and  apparatus  he  was  a  past  master.  He  held 
that,  so  far  as  possible,  wounds  should  be  closed  without 
stitches,  and  his  dressings  were  works  of  art.  Indeed,  in 
such  work  he  set  the  pace,  and  the  rare  beauty  and  method 
of  bandaging  and  apparatus  in  Boston  hospitals  are  con- 
spicuous to  this  day. 

In  one  respect  his  admiring  brother  and  biographer  does 
him  an  injustice,  for  he  tells  of  his  brilliancy  in  diagnosis 


XIX.  CENTURY.     EARLY    SURGEONS.      259 

and  how  he  would  form  his  opinion  at  a  glance.  For  the 
great  majority  of  common  lesions  this  was  doubtless  true; 
but  it  is  hard  to  believe  that  a  man  of  Warren's  careful 
and  accurate  mind  would  give  way  to  the  temptation  of 
what  we  call  "  snap  diagnosis,"  especially  in  those  ancient 
days,  when  instruments  of  precision  were  lacking  and  the 
science  of  pathology  was  just  struggling  into  life.  We 
have  copious  notes  of  his  clinical  remarks  made  at  the 
meetings  of  the  Boston  Society  for  Medical  Improvement, 
and  such  remarks  leave  with  us  a  feeling  that  he  came  to 
his  conclusions  only  after  careful  thought  and  the  ex- 
haustive comparing  of  conditions. 

About  the  time  of  the  Hospital's  founding  Warren  was 
at  the  very  height  of  his  career.  He  had  always  been 
rather  delicate  in  health,  and  it  had  been  his  constant  care 
to  guard  a  chronic  dyspepsia,  to  have  his  body  in  con- 
dition, to  keep  the  machine  in  good  working  order,  as 
we  say.  Yet  he  was  a  very  laborious  man.  It  was  his 
habit  to  rise  early  on  winter  mornings  and  breakfast  by 
candle-light;  then  he  went  out  and  made  professional 
visits  until  one  o'clock,  when  he  dined,  giving  himself 
about  ten  minutes  for  that  function.  He  saw  patients 
until  two,  when  he  lay  down  for  an  hour's  rest.  In  the 
latter  half  of  the  afternoon  he  made  further  visits,  supped 
at  seven,  and  spent  his  evenings  until  two  o'clock  in  the 
morning  at  his  books  and  in  writing.  On  hospital  and  lec- 
ture days  his  labors  were  still  further  prolonged.  It  was 
not  an  easy  or  self-indulgent  life. 

With  all  his  care  and  method,  Warren  was  not  a  timid 
operator.  His  amputations  were  bold  and  brilliant;  he 
removed  cataracts  with  great  success ;  he  taught  and  prac- 
tised operation  for  strangulated  hernia, — the  first  surgeon 
in  this  country  to  do  so,  and  against  strong  professional 
opinion  here;  he  introduced  the  operation  for  aneurism 
according  to  Hunter's  method.  His  excisions  of  bones 
for  tumor,  especially  the  jaws,  became  famous  and  are 


26o  MEDICINE    IN   AMERICA. 

classics,  for  are  they  not  recorded  in  volumes  of  the  Boston 
Medical  and  Surgical  Journal?  In  1837,  when  fifty-nine 
years  old,  he  published  his  magnum  opus^  "  Surgical  Ob- 
servations on  Tumors,"  a  thick  octavo  with  plates, — a 
great  collection  of  cases  and  remarks  interesting  and  in- 
structive to-day.  But  all  this  gives  only  a  very  faint  idea 
of  his  ceaseless  literary  activity.  He  was  always  writing ; 
reports,  memoirs,  essays,  and  lectures  poured  from  his  pen. 
It  was  a  ready  pen,  and  had  behind  it  a  brain  stored  with 
keen  thoughts  and  abundant  information. 

His  extra-professional  interests  were  multitudinous, 
and  few  men  have  felt  so  constantly  the  burden  of  their 
responsibilities  to  the  community.  He  was  like  an  officer 
on  dress  parade,  or  a  careful  father  in  the  presence  of  his 
)^oung  children,  always  punctilious  about  appearances.  He 
felt  it  must  not  be  said  that  a  man  of  his  eminence  or 
importance  ever  set  a  bad  example  or  appeared  to  disad- 
vantage; so  he  was  forward  in  good  works.  He  was 
dogmatic  and  final  in  his  decisions  and  explicit  with  his 
advice.  In  matters  surgical  his  word  was  law  for  many 
years,  and  it  was  not  until  his  old  age,  and  with  the  advent 
upon  the  scene  of  another  strong,  young,  and  aggressive 
man,  that  his  power  began  to  wane. 

With  his  own  advancing  years  he  also  saw  his  son,  J. 
Mason  Warren,  beginning  to  gain  the  public  confidence, 
and  so  he  found  time  to  devote  himself  more  to  work  out- 
side of  his  profession.  He  was  always  greatly  interested 
in  comparative  anatomy  and  paleontology.  Among 
other  trophies  he  was  able  to  secure  the  most  perfect 
skeleton  of  the  mastodon  which  exists  :  the  monster  is  still 
preserved  in  the  old  building  on  Chestnut  Street  which 
has  been  known  for  sixty  years  as  the  Warren  Museum. 
All  through  his  life  he  devoted  himself,  like  Hunter  and 
Cooper  before  him,  to  the  collection  of  anatomical  speci- 
mens. This  collection,  together  with  the  treasures  of  the 
Medical  Improvement  Society,  passed  years  ago  to  the 


XIX.  CENTURY..   EARLY    SURGEONS.      261 

Harvard  Medical  School  and  formed  the  nucleus  of  the 
fine  "  Warren  Museum"  of  that  institution.  In  middle 
life  he  became  a  convert  to  total  abstinence,  and  was  for 
many  years  President  of  the  Boston  Society  for  the  Pro- 
motion of  Temperance  in  the  Use  of  Alcohol.  He  was 
also  President  of  the  Natural  History  Society  of  Boston, 
and  was  an  active  member  of  the  Agricultural  Society. 
An  interesting  organization  for  the  promotion  of  scien- 
tific and  literary  pursuits  was  founded  by  him ;  it  included 
in  its  membership  many  of  the  most  eminent  and  scholarly 
men  of  Boston,  and  was  at  first  known  as  the  "  Warren 
Club."  Under  the  name  of  "  The  Thursday  Evening 
Club"  it  flourishes  to  this  day,  with  a  history  of  unbroken 
excellence  and  interest,  and  at  the  present  writing  is  pre- 
sided over  by  the  grandson  of  its  founder. 

Warren's  acquaintance  with  the  profession  in  this  coun- 
try and  in  Europe  was  extensive.  He  was  more  given  to 
travelling  than  was  the  wont  of  Bostonians  of  his  day, 
and  in  middle  life  made  an  extended  trip  to  Europe,  re- 
newing old  acquaintance,  seeing  society, — indeed,  with  his 
family,  he  was  present  in  London  at  the  time  of  Queen 
Victoria's  coronation, — and  visiting  the  homes  of  science 
at  the  fountain-head. 

He  was  prominent  in  the  establishment  of  the  American 
Medical  Association,  of  which  the  primal  purpose  was 
the  elevation  of  medicine  in  practice  and  in  teaching,  and 
he  was  one  of  its  early  presidents.  Of  all  these  things  we 
have  the  story  admirably  told  by  himself  in  his  published 
biography. 

Then  there  was  that  other  great  event  with  which  his 
name  is  most  conspicuously  connected :  the  first  public 
use  of  ether  anaesthesia  in  surgery.  That  was  in  October, 
1846,  when  he  was  approaching  his  seventieth  year,  an  age 
with  which  we  are  not  wont  to  associate  great  and  daring 
progress  in  affairs.  It  is  needless  here  to  enter  upon  this 
most  interesting  and  confused  chapter  of  American  sur- 


262  MEDICINE    IN    AMERICA. 

gery.  Suffice  it  to  admit,  as  Jacob  Bigelow  did  years 
aften\'ards,  that  to  Warren  belongs  the  credit,  in  his  old 
age,  of  allowing  his  name  and  position  to  stand  sponsor 
for  this  courageous  and  revolutionar}^  experiment.  A\^ar- 
ren  himself  was  too  near  the  end  of  his  career  to  benefit 
greatly  by  anaesthesia  in  surger}" ;  but  in  some  measure  he 
saw  its  significance,  and  wrote  about  it  and  championed  its 
uses  always. 

The  old  man  lived  until  1856.  Fifteen  years  before  his 
death  his  wife  died,  leaving  him  with  six  grown  children, 
and  two  years  later  he  married  a  daughter  of  Governor 
Thomas  Lindall  Winthrop,  who  also  died  before  him. 

He  kept  busy  almost  to  the  end  of  his  life,  especially 
with  his  writing.  His  last  surgical  paper  was  published 
in  May,  1855,  just  a  year  before  his  death,  which  closed  a 
brief  and  painful  illness. 

His  real  work  had,  however,  been  done  long  since.  It 
is  not  a  life  which  lends  itself  readily  to  eulog}-.  It  was 
not  full  of  striking  events  and  dramatic  incidents.  Ex- 
cept for  the  ether  episode,  no  event  stands-  out  conspicu- 
ously; and  in  that  he  simply  lent  his  name,  as,  indeed, 
but  for  him,  some  other  might  have  done.  But  it  was  his 
long  and  useful  career  that  made  him  eminent;  his  ser- 
vices in  helping  to  found  a  great  hospital,  his  establish- 
ment of  sound  surg'ical  methods,  his  correct  and  method- 
ical teaching,  his  faithful  searching  out  of  the  truth,  his 
insistence  upon  drill,  his  contempt  of  the  brilliant  super- 
ficial. All  these  things  were  very  important,  and  among 
us  helped  to  set  a  new  standard,  up  to  which  we  have  been 
growing  ever  since.  He  was  indeed  a  man  whose  work 
our  community  could  ill  have  spared ;  and,  though  he  was 
succeeded  by  the  meteoric  Henry  J.  Bigelow,  the  younger 
man  would  have  found  for  his  endeavors  a  very  different 
field  had  it  not  been  so  carefully  and  faithfully  tilled, 
through  toilsome  years,  by  Warren. 

In  the  lifetime  of  our  own  generation — in  January', 


XIX.  CENTURY.     EARLY    SURGEONS.      263 

1870 — there  died  in  Kentucky  an  old  man  who  had  been 
the  master  of  Western  surgery  forty  years  before, — Ben- 
jamin Winslow  Dudley.  Though  less  known  to  foreign 
readers  than  the  other  eminent  surgeons  of  whom  we  have 
heard,  and  though  leaving  behind  him  a  name  less  en- 
during in  our  surgical  literature,  his  power  and  his  imme- 
diate personal  influence  were  spread  over  a  wider  region 
than  were  those  of  all  his  distinguished  American  con- 
temporaries combined. 

He  was  of  Mott's  age, — born  on  April  12,  1785, — and 
therefore  fourteen  years  younger  than  his  famous  neigh- 
bor, Ephraim  McDowell ;  his  real  work  in  life  began  some 
five  years  after  that  pioneer  ovariotomy.  From  such 
scanty  memoranda  of  Dudley's  life  as  have  been  published 
one  concludes  that  its  early  chapters  must  have  been  full 
of  interest  and  adventure.  He  was  a  splendid  type  of  the 
Southwestern  frontiersman  turned  scientist :  bold,  deter- 
mined, clear-sighted,  devoted;  ready  with  fist  or  rifle; 
magnanimous,  enthusiastic.  Averse  to  learning  as  an  end, 
he  was  an  untiring  student  of  facts,  and,  with  a  single- 
hearted  devotion  to  surgery,  believed  in  his  profession  as 
the  one  incomparably  fine  pursuit  in  life.  He  was  a  born 
dictator,  irascible,  impatient  of  opposition,  intolerant  of 
humbug;  not  altogether  a  comfortable  man  to  live  with, 
we  must  believe,  and  often  at  odds  with  men.  Writers 
who  knew  him  speak  ill  and  well  of  him.  Gross  slurs  him 
as  "  the  knight  of  the  roller."  On  learning  of  his  death, 
Yandell  wrote  that  "  a  great  light  of  the  profession  has 
gone  out"  and  that  "  if  he  leaves  behind  him  any  superior 
in  our  country,  it  is  certain  that  no  one  of  all  our  surgeons 
has  occupied  a  larger  space  in  the  public  eye." 

He  was  not  only  a  great  operating  surgeon,  but  a  great 
teacher;  in  point  of  time  the  first  of  those  distinguished 
surgical  teachers  in  our  Middle  West  who  have  adorned 
the  American  profession. 

Like  so  many  other  eminent  Americans,  he  began  life 


264  MEDICINE    IN    AMERICA. 

under  grievous  disadvantages.  His  father,  Ambrose  Dud- 
ley, though  not  an  utterly  obscure  man,  was  poor,  being 
a  Baptist  minister  of  some  local  fame  as  a  preacher,  but 
unable  to  do  much  towards  starting  his  distinguished  son 
in  his  career. 

Like  McDowell,  young  Dudley  was  a  native  of  Vir- 
ginia, born  in  Spottsylvania  County;  but  his  father  was 
one  of  the  early  missionary  emigrants,  and  moved  into 
the  neighborhood  of  Lexington,  Kentucky,  while  the  son 
was  still  a  child.  In  the  town  of  Lexington  Benjamin 
Dudley  was  reared,  and  there  he  lived  out  his  life,  subject 
to  such  vicissitudes  of  fortune  and  experience  as  we, 
briefly,  shall  see. 

It  was  not  a  neighborhood  or  an  atmosphere  much 
given  to  learning  and  the  cultivation  of  the  graces  in  those 
early  days,  and  Dudley  grew  up  with  little  schooling  or 
love  of  study.  He  did  learn  to  write  well,  however,  and 
early  became  master  of  a  terse  and  vigorous  English.  It  is 
said  of  him  that  in  later  life  he  deeply  regretted  his  igno- 
rance of  the  classics,  and  was  sometimes  embarrassed  in 
the  society  of  scholars.  I  doubt  the  latter  statement.  Of 
him  one  may  say  truly  that  he  had  a  "  call."  From  his 
earliest  years  he  had  determined  to  be  a  doctor,  and  while 
still  veiy  young  he  began  his  professional  studies  in  the 
family  of  an  excellent  general  practitioner,  Frederick 
Ridgley. 

This  connection  meant  for  Dudley  the  usual  course 
of  desultory  reading  and  hack  work;  but,  fortunately 
for  him,  Ridgley  was  a  kindly  and  intelligent  man  who 
appreciated  the  early  promise  of  his  pupil  and  exerted 
himself  to  secure  wider  opportunities  for  the  youth.  Con- 
sequently, in  1804,  when  Dudley  was  nineteen  years  old, 
he  was  sent  to  the  Philadelphia  School,  whence  he  was 
graduated  in  course  two  years  later.  In  Philadelphia  he 
met  and  knew  three  men  with  whom,  later  in  life,  he  be- 
came associated  on  terms  of  both  friendship  and  enmity, 


XIX.  CENTURY.     EARLY    SURGEONS.      265 

— John  Esten  Cooke,  Daniel  Drake,  and  William  H. 
Richardson.  The  two  latter  were  poor,  ill-educated  lads 
like  himself,  and  from  his  own  State,  but  all  three  were 
destined  for  distinction  in  their  profession. 

Dudley  early  recognized  the  shortcomings  of  the  Ameri- 
can doctors.  Like  the  second  Warren,  in  Boston,  he  ap- 
preciated the  value  of  observation  and  the  importance  of 
scientific  work  as  it  was  to  be  found  at  its  best  in  Europe, 
and  he  began  to  see  dimly  what  is  so  clear  to  us  now,  that 
in  American  medicine  there  was  so  little  of  history  to 
record  because  men  were  learning  and  not  creating.  The 
wise  ones  among  his  teachers  could  tell  him  that;  and, 
with  such  thoughts  in  mind,  he  determined  that  somehow 
he  would  seek  out  those  great  foreign  scholars  for  him- 
self. But  how  to  do  it?  He  was  unknown,  without  in- 
fluence, and  penniless.  To  offset  that,  he  was  young,  vig- 
orous, clever,  and  determined;  so  forthwith,  in  1806,  he 
went  back  to  Lexington  and  proceeded  to  make  the  money 
he  needed.  Lexington  was  growing  in  importance  in 
those  days,  and  had  become  the  centre  of  a  great  district. 
Years  afterwards  Yandell  seriously  described  it  as  the 
literary  and  commercial  emporium  of  the  West  in  Dud- 
ley's younger  da5^s.  An  emporium  of  any  kind  seems  to 
be  a  good  place  for  the  strenuous  to  make  money  in,  and 
Dudley  was  one  of  that  sort.  There  was  not  much  money 
in  physic  in  those  ancient  da3^s,  but  it  had  to  be  made  in 
some  fashion,  so  Dudley  became  a  trader  as  well  as  a  doc- 
tor. He  was  moderately  successful  and  he  laid  by  funds. 
After  four  years  of  it  he  felt  himself  able  to  attempt  a 
grand  stroke.  He  put  all  his  money  in  his  purse,  loaded 
a  flat-boat  with  a  collection  of  "  sundries,"  and  drifted 
down  the  river  to  New  Orleans,  where  he  did  some  sharp 
trading,  invested  his  all  in  a  cargo  of  flour,  and  sailed 
boldly  for  Gibraltar.  It  was  a  fortunate  time  for  the 
young  American  to  be  taking  food  to  Europe.  The  Pen- 
insular war  was  at  its  height,  the  allied  armies  were  en- 


266  MEDICINE    IN   AMERICA. 

deavoring  to  drive  the  French  out  of  Spain,  commerce 
was  almost  at  a  stand-still,  and  prices  were  very  high. 
Dudley's  dealings  were  mostly  with  the  English  commis- 
sariat ;  he  disposed  of  his  cargo  for  a  large  sum  at  Gibral- 
tar and  Lisbon,  left  his  vessel,  pushed  through  Spain,  and 
reached  Paris  late  in  the  same  year.  In  Paris  he  remained 
nearly  four  years.  And  he  became  a  Frenchman  in  man- 
ner and  appearance, — a  Frenchman  of  the  first  empire. 
Those  rude  students  who  a  few  years  before  had  so 
troubled  his  countryman  from  Boston  seem  to  have 
amended  themselves  somewhat;  at  any  rate,  Dudley  was 
not  greatly  disturbed  by  them,  but  settled  down  to  his 
work  and  proceeded  to  absorb  facts.  Facts  were  what  he 
had  come  for. 

Baron  Larrey  was  then  the  great  man  in  France. 
His  fame  was  building  as  yet  and  the  Russian  cam- 
paign was  still  two  years  away.  The  influence  and  teach- 
ing of  Larrey  made  a  profound  impression  on  Dudley, 
who  always  regarded  him  as  the  greatest  of  French  sur- 
geons, though  he  placed  him  after  the  two  Englishmen, 
Cooper  and  Abernethy.  It  was  Larrey' s  treatment  of 
wounds  after  operation  which  impressed  him  most;  in- 
deed, later,  Larrey,  Dudley,  and  Samson  Gamgee  were 
the  conspicuous  advocates  of  surgical  rest  and  support, — 
a  doctrine  so  sound  and  true,  and  so  ancient  withal,  that 
its  frequent  neglect  in  these  aseptic  days  seems  a  reproach 
to  modern  methods. 

Larrey's  surgical  memoirs  are  fascinating  reading  still, 
and  his  reports  of  the  success  of  major  amputations  per- 
formed on  the  field,  sealed  up  tightly,  and  left  undisturbed 
for  many  days  in  firmly  supporting  bandages  are  as  con- 
vincing and  instructive  as  ever.  He  was  the  first  surgeon 
to  introduce  and  teach  the  use  of  plaster  of  Paris,  for 
which  alone  he  deserves  our  thanks. 

The  student  days  of  a  century  ago  were  noted  for  the 
eager  pursuit  of  anatomy.     For  the  first  time  in  surgical 


XIX.  CENTURY.     EARLY    SURGEONS.      267 

history  opportunities  for  genuine  careful  dissecting  were 
offered;  and,  thanks  to  Napoleon,  Paris  was  the  place 
where  "  material"  could  be  had  in  abundance.  Those  were 
golden  days  in  the  life  of  France.  For  the  first  time  in 
the  nation's  history  merit  was  being  recognized,  and 
young  men  were  crowding  into  the  professions  with  the 
certain  knowledge  that  advancement  and  honors  were  no 
longer  dependent  on  birth  and  favor.  That  great  intel- 
lectual expansion  of  the  nineteenth  century  was  begin- 
ning and  Dudley  was  there  at  its  source.  Progress  was 
in  the  air,  and  the  brilliant  men  of  whom  we  have  already 
made  some  note  were  the  masters  under  whom  he  sat. 

Most  of  Dudley's  three  and  a  half  years  in  Europe  were 
spent  in  Paris,  though  he  saw  enough  of  the  practice  of 
Great  Britain  to  be  impressed  by  its  famous  surgeons  of 
the  day.  Throughout  his  after-life  his  manner  and  bear- 
ing were  French,  but  his  professional  method  and  practice 
were  English.  That  latter  statement  I  take  to  mean  that 
he  was,  lirst  of  all,  humane  and  wise  in  his  attitude 
towards  his  patients ;  that  he  treated  them  as  individuals 
rather  than  as  material;  that  he  reasoned  from  sound, 
observed  premises ;  that  he  operated  for  the  patients'  sake 
and  not  for  his  own;  that  in  all  matters  of  hygiene  and 
the  "  after-care"  of  surgical  cases  he  was  particular  and 
conscientious;  and  that  by  tonics,  food,  and  nursing  he 
sought  to  re-establish  the  normal  vigor  of  the  system. 

The  old  spirit  of  caste  and  of  class  superiority  was  not 
extinct  in  France,  although  the  Revolution  had  come  and 
gone.  The  educated  physician  regarded  himself  and  was 
regarded  by  the  masses  as  a  very  superior  person.  We 
see  the  same  thing  still  in  the  Continental  hospitals,  where 
the  poor  peasant  or  the  simple  artisan,  his  wife  and  chil- 
dren, are  but  humble,  dumb  things,  brought  in  and  out, 
timidly  obedient  to  the  professor's  order;  and  we  pride 
ourselves  that  with  us  those  things  are  never  so.  The  dis- 
tinction certainly  is  a  very  marked  one,  and  the  hospital- 


268  MEDICINE    IN   AMERICA. 

ized  physician  of  the  Continent  has  much,  in  such  training, 
to  contend  with  when  he  finds  himself  confronted  with 
his  social  equals  as  patients.  English-speaking  folk  are 
in  accord  that  the  best  doctors  of  the  Continent  are  not 
agreeable  practitioners,  though  this  may  not  be  true  of  the 
suave  commercial  gentry  who  haunt  the  Spas,  cajoling 
and  practising  upon  the  minds  and  bodies  of  unfortunate 
Americans  travelling  for  health. 

However,  though  "  cures"  and  quacks  abounded  in 
Dudley's  days,  as  in  our  own,  he  himself  had  fallen  into 
good  hands,  had  observed  and  learned  many  things,  and 
at  last,  in  1814,  with  a  lean  purse  but  a  goodly  store  of 
wisdom,  he  sailed  again  for  America  and  the  Kentucky 
wilds. 

When  Dudley  returned  home  he  was  twenty-nine  years 
old, — far  more  mature  than  were  the  other  beginners  of 
that  time, — and  he  entered  upon  a  field  in  which  McDowell 
was  his  only  serious  rival.  Rarely  has  America  produced 
a  man  so  entirely  devoted  to  his  profession.  His  complete 
absorption  in  science  so  held  him  that  as  long  as  he  lived 
to  work  his  mind  had  no  place  for  other  things.  He  was 
not  an  all-round  man  like  some  others — like  McDowell, 
for  instance;  he  knew  nothing  but  his  cases  and  the  things 
pertaining  thereto.  He  hated  recreation  and  sports  and 
travel.  Literature  that  was  not  medical  was  as  nothing 
to  him.  The  consequence  was  that  he  led  a  one-sided  life, 
he  made  few  intimate  friends,  though  his  admirers  were 
legion,  and  he  lacked  a  true  perspective  of  men  and  things. 

As  a  mere  surgeon  he  soon  eclipsed  even  McDowell, 
and  when  his  great  talents  as  a  teacher  became  conspicu- 
ous, his  fame  was  vaunted  and  spread  abroad  far  more 
widely  than  that  of  his  modest,  kindly,  and  gifted  senior. 
As  a  practitioner  of  medicine  Dudley  was  never  great,  but 
it  was  for  his  treatment  of  the  surgical  aspects  of  general 
disease  that  he  first  became  known.  When  he  arrived  in 
Kentucky  from  Europe  a  fierce  and  fatal  epidemic  of  what 


XIX.  CENTURY.     EARLY    SURGEONS.      269 

was  called  "  bilious  fever"  was  raging,  resulting  com- 
monly in  leaving  the  patient  crippled,  with  obstinate  ulcers 
of  the  legs,  a  pons  asinorum  to  the  medical  community. 
Here  was  a  problem  simple  enough  to  the  eye  of  expe- 
rience, and  Dudley  promptly  made  himself  famous  for  the 
treatment  of  these  troubles  on  well-established  surgical 
principles.  Rest,  elevation,  and  elastic  compression  were 
the  familiar  means  he  used,  and  his  cures  were  regarded 
as  miracles. 

The  question  arises  whether  he  did  not  overdo  a  good 
thing  and  overpersuade  himself;  whether  his  success  in 
these  methods,  when  suitably  applied,  did  not  incline  him 
to  their  use  in  unsuitable  cases.  Certain  it  is  that  such  a 
charge  was  often  brought  against  him.  Gross  dubbed  him 
"  the  knight  of  the  roller;"  but  the  facts  now  seem  to  be 
that  his  disciples  undid  him  there  and,  like  Rush's  young 
advocates  of  bleeding,  brought  discredit  upon  the  man 
they  followed. 

Of  Dudley,  as  of  all  those  other  men,  we  ask  ourselves. 
Why  was  he  famous?  What  great  thing  did  he  do?  I 
suppose  the  answer  in  this  case  would  be  that  he  was  a 
great  lithotomist, — a  remover  of  stones  from  bladders. 
In  this,  they  say,  he  succeeded  better  than  all  other  sur- 
geons. In  the  course  of  some  forty  years'  practice  he  cut 
for  stone  two  hundred  and  twenty-five  times,  and  the  first 
hundred  without  a  death.  He  was  a  clever  handicrafts- 
man, but  cautious,  selecting  carefully  his  cases,  which 
means,  perhaps,  that  he  never  operated  on  a  feeble  person, 
lest  he  should  die.  Certainly  an  excellent  rule  for  avoid- 
ing a  high  mortality — excellent  especially  in  those  cases  in 
which  commonly  the  patients  come  exhausted  from  long- 
continued  pain  and  discomfort.  He  himself  attributed  his 
success  to  the  care  with  which  he  prepared  his  patients  for 
the  operation.  Be  all  of  which  as  it  may,  he  excelled  even 
Physick  in  such  work. 

He  was  original  as  well  as  careful ;   he  convinced  him- 


270 


MEDICINE    IN    AMERICA. 


self  that  certain  forms  of  epilepsy  are  due  to  mechanical 
pressure  on  the  brain,  owing  to  old  unrecognized  fracture, 
and  he  proceeded,  but  most  tardily,  to  report  his  theorem, 
for  he  hated  writing.  His  friends  Cook  and  Short,  editors 
of  the  Transylvania  Journal  of  Medicine,  finally  dragged 
the  communication  out  of  him,  and  in  February,  1828,  he 
published  in  their  journal  a  paper  on  traumatic  epilepsy 
which  created  a  genuine  sensation.  His  conclusions  were 
based  on  five  cases  on  which  he  had  operated,  with  a  re- 
sulting cure  m  three  and  marked  benefit  in  the  other  two. 
The  subject  was  not  a  new  one,  but  Dudley's  figures  were, 
and  the  impetus  given  to  cranial  surgery  was  great.  Of 
course,  the  prevailing  lack  of  surgical  cleanliness  at  that 
time  made  all  such  work  most  hazardous,  and  it  was  not 
until  fifty  years  later  that  such  operations  began  to  be 
comparatively  free  from  danger  to  life.  One  of  the  points 
made  by  Dudley  in  this  connection  was  his  treatment  of 
hernia  cerebri,  or  great  fungus  outgrown  from  the  brain, 
following  extensive  injury  to  the  skull.  He  asserted  that 
he  had  reduced  this  condition  by  steady  pressure  under 
sponges  and  bandages.  Certain  of  his  cases  are  said  to 
have  been  cured  in  five  days;  but  such  statements  make 
one  feel  somewhat  doubtful  of  his  judgment  or  veracity, 
as  hernia  of  the  brain  is  now  known  to  be  due  to  inflam- 
mations which  are  hardly  susceptible  of  cure  in  five  days 
and  by  simple  pressure. 

In  the  next  number  of  the  Journal  Dudley  described  a 
new  operation  for  hydrocele  by  excision  of  the  sac, — a 
manoeuvre  now  commonly  employed  and  of  the  greatest 
radical  value.  Another  series  of  articles  on  the  use  of  the 
bandage  followed ;  then  one  on  fractures  and  one  on  stone 
in  the  bladder. 

These  few  papers  are  the  extent  of  his  published 
writings.  He  understood  perfectly  that  it  is  the  men  who 
write  and  teach  who  are  remembered ;  and,  in  spite  of  his 
dislike  of  writing,  he  performed  his  laborious  part  so  far. 


XIX.  CENTURY.     EARLY    SURGEONS.      271 

The  papers  are  striking-  and  interesting.  The  pity  of  it  is 
that  we  have  no  more  of  them. 

There  were  fields  other  than  medical  literature  for  Dud- 
ley's energies,  and  his  energies  were  active  enough.  It 
was  teaching  that  he  mostly  cared  for.  He  had  ver}-  posi- 
tive ideas  of  surgical  work  and  he  loved  to  describe  them. 
He  was  not  brilliant,  or  meteoric,  or  dramatic.  He 
never  '  played  to  the  galleries,"  but  he  was  immensely 
popular  as  a  teacher.  He  had  learned  that  thing  which 
escapes  so  many  of  the  clever  self-centred  men  whom  we 
call  professors :  medical  students  are  overworked ;  they 
are  struggling  with  a  multitude  of  subjects;  their  time  is 
limited,  and  they  want  only  the  brief,  cold  facts,  so  pre- 
sented that  the  association  is  obvious  and  the  impression 
lasting.  If  a  class  of  young  men  is  involved  in  the  serious 
study  of  the  anatomy  and  treatment  of  hernia,  they  have 
no  wish  for  dramatic  descriptions  of  the  teacher's  latest 
case  of  appendicitis ;  yet  such  is  the  sort  of  thing  to  which 
they  are  often  subjected  by  men  of  real  ability.  The  suc- 
cessful doctor,  especially  the  surgeon,  is  tempted  to  dilate 
at  undue  length  on  what  immediately  interests  himself. 
To  this  class  Dudley  did  not  belong.  His  lectures  were 
carefully  arranged  and  without  brilliancy;  they  were 
clear,  terse,  and  intensely  interesting.  He  was  dogmatic 
and  final,  but  that  is  what  young  students  appreciate.  He 
was  often  original,  too,  and  impressed  his  personality  per- 
manently upon  his  hearers.  \A*hile  he  was  young,  vigor- 
ous, and  pre-eminent  he  was  the  one  great  authority ;  when 
he  grew  old,  and  rivals  appeared  in  his  field,  he  retired. 
He  had  grasped  the  meaning  of  science  in  fair  measure, 
but,  like  so  many  of  us  even  to-day,  success  made  him  in- 
tolerant, and  so  his  value  became  lessened.  The  autocrat 
in  science  occupies  a  very  perilous  position.  Xo  man's 
mere  word,  without  proof,  is  to  be  accepted. 

Dudley  returned  from  Europe  to  his  old  friends  with  a 
\ery  good  idea  of  himself,  but  full  of  the  useful  ambition 


272  MEDICINE    IN    AMERICA. 

to  advance  medicine  by  teaching.  At  first  he  contented 
himself,  like  the  others,  with  taking  private  classes;  but 
in  1817,  after  he  had  been  three  years  in  practice,  he  saw 
his  opportunity  and  induced  the  trustees  of  Transylvania 
University,  in  Lexington,  to  establish  a  medical  depart- 
ment. This  was  the  first  of  the  great  Medical  Schools  of 
the  West.  Nominally,  the  Transylvania  School  had 
existed  since  1799,  though  in  most  futile  fashion;  but 
now,  with  the  advent  of  new  blood,  it  started  on  a  fresh 
and  prosperous  career. 

The  reorganized  School  contained  some  strong  teach- 
ers. Drake  was  made  Professor  of  Materia  Medica  and 
Richardson  Professor  of  Obstetrics.  Overton  held  the 
chair  of  Medicine,  Rev.  James  Blythe,  D.D.,  that  of  Chem- 
isti*y,  and  Dudley  that  of  Anatomy  and  Surgery.  A  small 
but  earnest  body  of  students  attended  the  lectures,  and  in 
the  spring  of  1818  there  was  graduated  one  Doctor  of 
Medicine,  W.  L.  Sutton,  afterwards  widely  known  in 
Kentucky. 

That  first  winter  was  a  stormy  one  for  the  youthful 
faculty;  indeed,  it  was  so  stormy  that  they  broke  up  in 
a  row.  The  School  was,  in  effect,  a  private  enterprise,  as 
were  so  many  in  those  years,  and  the  vicious  system  bred 
its  natural  results.  Each  man  wanted  to  conduct  the 
course  after  his  own  fashion,  and  matters  of  precedence 
were  found  impossible  of  arrangement.  There  was  no  en- 
dowment worth  mentioning,  and  the  School  was  depend- 
ent on  the  fees  of  pupils.  There  was  little  money  left  for 
the  teachers;  so  the  faculty  came  literally  to  blows.  In 
disgust,  Drake  went  to  Cincinnati  to  help  start  a  school 
there,  and  Overton  removed  to  Nashville.  The  men  who 
were  left  displayed  more  enmity  than  ever,  and,  not  con- 
tent with  the  quarrel  within  doors,  took  to  libelling  one 
another  in  pamphlets  without.  Dudley  and  Richardson 
were  the  chief  sinners.  The  bad  blood  would  not  down, 
and  nothing  would  satisfy  the  men  but  a  duel,  which  was 


XIX.  CENTURY.  EARLY  SURGEONS.   273 

finally  arranged.  Strangely  enough,  this  absurd  method 
solved  the  difficulty.  They  sallied  forth  to  kill,  but  re- 
turned good  friends — Richardson  with  a  pistol  bullet  in 
his  thigh,  quite  harmless,  as  it  proved — and  went  on  to 
compound  a  new  faculty.  Meantime  the  poor  School  had 
been  completely  bedevilled  and  a  year  lost;  but  in  1819 
another  start  was  made,  and  for  forty  years  the  founda- 
tion survived.  In  1859,  in  other  times  and  in  the  hands 
of  other  men,  it  was  finally  dissolved,  the  greater  colleges 
of  large  neighboring  towns  having  thrown  it  out  of  action. 
But  for  some  twenty  years  of  its  youth  it  did  a  useful  and 
brilliant  work;  it  graduated  nearly  two  thousand  stu- 
dents, roughly  equipped  for  practice,  and  it  carried  on  its 
rolls  many  well-known  names. 

During  those  years,  from  1820  to  1840,  Dudley  was  the 
most  conspicuous  figure  in  the  company  of  able  men  who 
made  the  School  what  it  was.  Charles  Caldwell  and 
Samuel  Brown  were  of  his  colleagues, — names  still  re- 
membered in  the  Middle  West.  In  that  period  the  Tran- 
sylvania institution  began  to  be  known  beyond  the  State, 
and  among  the  young  schools  of  America  it  seems  to  have 
ranked  with  the  first  six,  —  with  those  of  Philadelphia, 
New  York,  Boston,  Hanover,  and  Baltimore. 

The  later  history  of  the  Lexington  School  is  instructive. 
The  town  was  too  small  and  the  clinical  advantages  too 
few  to  insure  a  permanent  success  in  competition  with  ad- 
jacent towns  such  as  Louisville  and  Cincinnati,  but  so 
long  as  Dudley  maintained  his  vigor  the  School  lived. 
Finally,  however,  in  1837,  the  new  College  at  Louisville 
proved  too  attractive  for  the  young  and  ambitious  among 
the  Transylvanians ;  so,  leaving  Dudley,  who  refused  to 
move,  they  migrated  to  the  larger  place.  Caldwell  led  the 
way  and  remained  for  years  a  power  there;  then  there 
was  Cooke,  and  Yandell,  the  most  famous  of  all.  In  this 
School  were  also  Cobb,  Miller,  Drake,  J.  B.  Flint,  and  S. 
D.  Gross  in  his  early  years. 

18 


2/4  MEDICINE    IN    AMERICA. 

Of  all  those  men,  Caldwell  was  much  the  senior,  being 
thirteen  years  older  than  Dudley  himself.  He  was  a  vig- 
orous, eloquent,  able,  opinionated,  and  often  wrong- 
headed  man.  He  was  a  North  Carolinian  of  Irish  parent- 
age, educated  in  Philadelphia,  and  a  pupil  of  Rush,  of 
whom  he  wrote  critically  later,  opposing  especially  his 
views  on  yellow  fever.  Many  of  the  early  years  of  his  life 
were  devoted  to  writing  rather  than  to  practice,  and  he 
became  well  known  throughout  the  country.  His  first 
serious  teaching  was  undertaken  on  the  invitation  of  the 
Transylvania  School.  He  was  a  very  busy  man,  writing, 
talking,  and  manoeuvring  in  medical  politics  all  his  life. 
The  total  mass  of  his  pubhcations  was  enormous — greater 
than  that  of  almost  any  other  American — but  ephemeral. 
Of  all  that  he  left,  his  Autobiography  only  is  worth 
reading. 

In  1 8 19  Dudley's  best  work  began,  that  excellent  teach- 
ing which  made  him  famous,  and  his  surgical  practice 
grew  rapidly.  With  the  early  decline  and  retirement  of 
McDowell  he  came  to  dominate  the  wide,  new  Western 
country  and  was  called  in  all  directions  far  beyond  the 
State.  It  is  not  difficult  to  understand  his  prominence. 
No  one  for  a  thousand  miles  around  was  so  well  equipped 
for  surgery,  and  he  possessed,  besides,  that  resourceful- 
ness, sound  judgment,  experience,  and  mechanical  skill 
which  go  to  make  a  great  operator. 

Of  his  manner  and  method  in  teaching  enough  has  been 
said,  and  so  we  must  conceive  the  man  an  autocrat  in  his 
own  field  for  more  than  twenty  years. 

His  fees  were  large  and  his  early  experiences  had  made 
him  a  good  man  of  business.  At  the  age  of  thirty-six  he 
married  Miss  Anna  Maria  Short,  a  daughter  of  Major 
Peyton  Short,  and  they  had  three  children,  his  eldest  son, 
Wilkins  Dudley,  following  him  in  medicine. 

In  spite  of  his  remarkal)le  eminence  during  middle  life, 
Dudley's  career  failed  to  make  a  permanent  impression. 


XIX.  CENTURY.     EARLY    SURGEONS.      275 

Just  why  this  was  so  is  not  entirely  evident.  His  influence 
faded  gradually  long  before  his  death,  and  with  the  closing 
of  the  Lexington  School  he  ceased  to  be  conspicuous.  He 
had  laid  aside  money  and  built  himself  a  comfortable 
country  house.  Thither  he  retired  about  1850,  and,  linger- 
ing for  twenty  years  in  increasing  physical  and  mental 
debility,  survived  the  Civil  War  and  died  in  1870. 

It  was  a  painful  anticlimax.  The  profession  had  almost 
forgotten  him,  and  the  brief  record  of  his  old  friend  and 
pupil,  Yandell,  alone  remains  to  tell  the  story  of  what 
promised  to  be  a  most  useful  as  well  as  most  romantic  life. 


CHAPTER    XL 

THE    NINETEENTH    CENTURY,       SOME    EARLY    PHYSICIANS 
AND   THEIR  PROBLEMS. 

It  was  a  simple  task  to  select  the  eminent  American  sur- 
geons of  a  hundred  years  ago  and  to  tell  why  they  were 
great,  but  to  do  the  same  with  the  physicians  is  a  less  easy 
matter.  Not  that  we  lacked  physicians  of  eminence,  for 
have  we  not  read  of  Benjamin  Rush?  but  the  then  exist- 
ing American  conditions  made  a  conspicuous  pre-eminence 
and  a  permanent  fame  in  internal  medicine  here  a  most 
unlikely  thing.  There  was  little  time  or  opportunity  for 
closet  study  and  laboratory  research,  and  science  was  not 
properly  fostered  in  the  universities.  The  professional 
physicians  were  amateur  teachers  and  students.  Even  the 
best  minds,  with  rare  exceptions,  were  engrossed  with 
what  are  called  the  practical  affairs  of  life.  A  Haller  or  a 
Bichat  could  scarcely  have  thriven  in  such  an  atmosphere. 
Daring  surgeons  who  were  good  anatomists  could  per- 
form new  and  brilliant  operations  with  dexterity,  but 
medicine  proper  offers  few  occasions  for  daring  or  bril- 
liancy. Moreover,  the  methods  of  science  were  misunder- 
stood or  despised.  The  great  Cullen  himself,  and  Brown, 
his  plausible  rival,  founded  their  practice  and  teaching  on 
a  priori  reasoning,  and  Cullen  declared  it  to  be  the  duty 
of  a  philosophical  inquirer  in  medicine  to  control  his  ob- 
servations by  his  theories  and  not  his  theories  by  his 
observations.  With  that  example,  it  was  small  wonder 
that  American  practice  was  largely  empirical,  though  even 
a  hundred  years  ago  the  new  light  was  beginning  to  shine 
feebly  into  these  dark  corners  of  the  earth  and  the  spirit 
of  inquiry  and  emancipation  was  abroad. 

At  the  end  of  the  eighteenth  century  Waterhouse,  of 
276 


XIX.  CENTURY.     EARLY    PHYSICIANS.     277 

Harvard,  introduced  vaccination,  and  Jackson  soon  after 
began  the  practice  in  Boston.  This  was  two  years  before 
Jenner's  first  famous  announcement  of  his  discovery,  upon 
which  his  paper  was  immediately  reproduced  in  America, 
and  a  careful  resume  was  published  in  Mitchell  &  Miller's 
Medical  Repository,^  the  only  authoritative  medical  jour- 
nal then  existing  among  us. 

The  novel  proposition  was  accepted  much  more  readily 
here  than  it  had  been  in  England,  and  the  practice  ob- 
tained a  strong  foothold  in  a  very  few  years. 

But,  in  spite  of  such  sane  and  eminent  men  as  we  have 
described  in  former  pages,  the  general  practice  and  knowl- 
edge of  the  times  were  most  lamentable.  These  facts  have 
been  greatly  dwelt  upon  already,  especially  in  describing 
the  conditions  prevailing  in  the  eighteenth  century;  but 
with  the  loosing  of  the  democratic  spirit  in  the  land, 
quackery  and  unlicensed  methods  of  practice  became  more 
rampant  than  ever  before.  No  retrospect  of  ours  can  make 
out  a  worse  case  than  actually  existed,  as  described  by 
one  of  the  most  eminent  of  contemporary  writers  nearly 
a  hundred  years  ago.    In  181 3  David  Hosack  wrote, — 

"  The  great  disparity  in  the  merits  of  those  who  belong 
to  the  medical  profession  is  a  topic  of  daily  converse  and 
public  notoriety.  As  the  high  opinion,  which  in  all  ages 
has  been  entertained  of  the  professors  of  the  healing  art, 
must  have  been  founded  not  upon  any  adventitious  cir- 
cumstances but  upon  the  very  nature  of  the  profession 
itself  and  the  abilities  and  acquirements  of  those  who  un- 
dertook to  discharge  its  important  duties,  one  seems  nat- 
urally led  to  examine  the  merits  and  conduct  of  those  who 
lay  claim  to  a  like  consideration  in  the  community,  and  to 
ascertain  upon  what  grounds  they  assume  a  rank  and  im- 
portance among  mankind,  the  reward  only  of  command- 
ing talents,  severe  application  and  moral  excellence. 


^  Medical  Repository,  1799,  vol.  ii.  p.  255. 


278  MEDICINE    IN    AMERICA. 

"  That  almost  every  district  of  our  country  abounds 
with  individuals  who  set  up  to  exercise  the  duties  of  prac- 
titioners of  medicine,  need  scarcely  be  stated ;  how  great 
is  the  number  of  them  who  are  totally  ignorant  of  the  first 
principles  of  their  profession  and  who  degrade  the  noblest 
of  studies  into  the  meanest  of  arts,  cannot  have  escaped 
the  attention  of  any  who  at  all  regard  the  interests  of 
society.  .  .  .  Though  they  differ  from  beasts  of  prey, 
.  .  .  yet  they  wage  war  with  equal  success  as  it  regards 
the  destruction  of  their  objects.  .  .  .  The  inroads  and 
depredations  which  they  commit  bid  defiance  to  all  calcu- 
lation. .  .  .  The  necessity  of  something  like  medical  re- 
forms is  obvious,  and  the  learned  and  the  liberal  in  every 
quarter  are  called  upon  in  behalf  of  so  beneficial  an  under- 
taking. The  degraded  state  of  medical  science  renders 
necessary  the  united  exertions  of  all,  if  we  wish  to  restore 
the  healing  art  to  its  wonted  dignity.  It  were  not  less 
absurd  to  expect  light  to  spring  out  of  darkness  than  to 
expect  that  a  science,  in  itself  liberal  and  dignified  as  that 
of  medicine,  should  receive  any  support  from  the  ignoble 
and  the  vulgar;  that  the  complicated  structure  of  the 
human  frame  and  the  pathology  of  disease  should  be  un- 
derstood by  men,  who  from  education,  knowledge,  and 
intellect  are  fit  only  to  discharge  the  duties  of  some  menial 
office;  that  a  profession  in  the  attainment  of  which  an 
expenditure  of  some  wealth  and  a  long  and  severe  appli- 
cation is  required  should  be  comprehended  by  the  indalent 
and  those  whose  attention  is  directed  solely  to  the  acquisi- 
tion of  money,  and  whose  minds  are  as  gross  and  heavy 
as  the  metal  for  which  they  toil.  By  a  steady  and  fearless 
perseverance,  we  are  persuaded  that,  in  no  great  length 
of  time  the  character  of  our  profession  will  be  rescued 
from  the  disgraceful  condition  to  which  it  has  been  re- 
duced. Let  not  the  mere  compounder  of  drugs,  whose  ac- 
quirements enable  him  to  do  little  more  than  to  distinguish 
rhubarb  from  bark,  enjoy  all  the  rights  and  immunities 


XIX.  CENTURY.     EARLY    PHYSICIANS.     279 

of  regular  college  graduates;  and  as  we  deem  it  neces- 
sary that  a  series  of  years  should  be  spent  in  order  to  han- 
dle the  last  and  the  awl,  let  us  require  at  least  an  equal 
portion  of  time  to  be  devoted  to  study,  to  qualify  an  in- 
dividual for  the  exercise  of  those  duties  upon  a  proper 
performance  of  which  the  lives  and  happiness  of  his  fel- 
low creatures  depend." 

Such  were  the  conditions  which  Hosack  deplores,  but 
he  proceeds  confidently  to  indicate  the  remedy — a  more 
thorough  education — and  to  point  out  the  necessity  of  a 
higher  ethical  standard.  Indeed,  the  medical  ethics  of  the 
time  were  unhappy,  and,  even  in  the  best  scientific  circles, 
backbiting,  innuendo,  grabbing,  and  "  sharking"  were  all 
too  common.  Hosack  goes  on  to  quote  Middleton,  who 
wrote  in  the  same  vein  forty  years  before,  lamenting  the 
debased  state  of  the  profession;  and  he  asserts  that  in 
181 3  the  conditions  were  far  worse  even  than  those  which 
Middleton  described.  It  is  allowed  us  in  this  twentieth 
century  to  assert,  without  undue  complacency,  that  in 
these  respects  we  are  better  than  our  ancestors  were. 

Hosack' s  description  referred  most  especially  to  the  con- 
ditions in  New  York  State,  but  it  is  only  fair  to  say  that 
the  situation  was  the  same  throughout  the  country.  Legis- 
lators were  too  busy  with  the  needs  of  their  seething, 
expanding  communities  to  concern  themselves  much  about 
matters  pertaining  to  the  professions  and  to  higher  edu- 
cation; so  that,  lawyers  only  excepted,  one  found  the 
great  mass  of  men — doctors,  ministers,  teachers,  archi- 
tects, engineers,  carpenters,  masons,  and  craftsmen  of  all 
descriptions,  outside  of  the  few  great  centres — to  be  self- 
taught,  crude,  blundering,  and  inexpert. 

Of  course  this  brought  all  sorts  of  so-called  skilled  ser- 
vice into  deserved  popular  contempt  and  greatly  developed 
the  already  existing  feeling  that  one  man  was  about  as 
good  as  another  in  whatever  line  of  work  his  fancy  might 
lead  him  to  experiment.    In  those  days  the  serious,  stead- 


28o  MEDICINE    IN    AMERICA. 

fast  following  of  one  occupation  through  life  was  the 
exception  rather  than  the  rule;  jacks-of-all-trades  were 
everywhere  found;  and  one  saw,  without  the  slightest 
surprise,  farriers  turned  doctors,  lawyers  turned  minis- 
ters, ministers  turned  farmers,  and  farmers  turned  states- 
men. Specialists  and  experts  were  almost  unknown,  ex- 
cept among  the  old-fashioned  colonial  artisans,  among  the 
clergy  and  the  politicians.  The  common  doctors  were 
both  shrewd  and  clever;  and,  following  the  lead  of  the 
best  educated  in  the  profession,  they  built  up  abundant 
theories,  which  they  loudly  preached.  In  these  days  we 
are  told  of  the  decline  of  sensibility.  Truly,  sensibility 
seems  to  have  been  a  rare  trait  among  American  doctors  a 
hundred  years  ago.  The  best  standards  were  low :  one 
has  but  to  read  the  lives  of  some  of  the  men  memorialized 
by  Thacher  in  his  "  American  Medical  Biography"  to  ap- 
preciate that.  The  most  preposterous  claims  and  actions, 
if  credited  to  a  man  loud  enough  in  his  religious  profes- 
sions, were  apt  to  be  tolerated  and  approved. 

One  of  the  most  curious  examples  of  that  kind — an 
episode  in  which  the  principal  actor  was  an  entirely  re- 
spectable man — might  be  called  "  The  Legend  of  Perkins 
and  his  Metallic  Tractors." 

Elisha  Perkins  was  a  shrewd  son  of  Connecticut,  bom 
about  the  middle  of  the  eighteenth  century  and  crudely 
trained  for  the  practice  of  medicine  by  his  father,  himself 
an  excellent  physician  for  his  time.  "  Doctor"  by  cour- 
tesy, as  were  most  of  his  contemporaries,  the  younger 
Perkins  became  a  successful  and  widely  known  practi- 
tioner. Six  feet  tall,  handsome,  of  commanding  personal- 
ity, and  full  of  that  intangible  something  which  women 
call  charm  and  men  call  magnetism,  he  became  in  a  few 
years  one  of  the  most  popular  and  successful  doctors  in 
Connecticut.  As  Thacher  puts  it,  "  He  was  esteemed  as 
a  man  of  strict  honor  and  integrity  of  character." 

He  was  greatly  impressed  during  his  career  with  the 


XIX.  CENTURY.     EARLY    PHYSICIANS.     281 

sense  of  benefit  and  well-being  which  his  forceful  presence 
and  kindly  ways  imparted  to  his  patients,  especially  when 
he  had  occasion  to  lay  his  hands  upon  them  in  the  course 
of  making  examinations  or  feeling  the  pulse.  This  effect 
he  thought  to  be  due  to  some  occult  magnetic  influence, 
and,  bearing  in  mind  Dr.  Franklin's  researches,  he  per- 
suaded himself  that,  by  combining  together  certain  metals, 
a  more  efficient  magnetic  or  electro-therapeutic  agent 
might  be  secured  than  by  the  mere  human  touch.  After 
experimenting  for  several  years,  he  developed  an  appa- 
ratus that  satisfied  him.  This  consisted  merely  of  "  two 
instruments,  one  having  the  appearance  of  steel,  the  other 
of  brass;"  the  ends  were  brought  to  a  point,  and  were  ap- 
plied to  the  patient  by  drawing  the  points,  in  a  downward 
direction,  over  the  affected  parts  for  a  period  of  twenty 
minutes. 

These  were  the  instrtiments  which  became  famous  for 
a  period  and  were  known  as  "  Perkins's  Metallic  Trac- 
tors." He  took  out  a  patent  and  proceeded  to  put  his 
goods  upon  the  market.  That  is  the  only  circumstance 
that  interests  us  now  in  connection  with  Elisha  Perkins, — 
the  patent  and  the  exploitation.  It  is  in  itself  a  little 
sermon  on  the  standards  of  the  time.  The  man  does  not 
appear  to  have  lost  caste.  He  gained  many  followers  and 
was  consulted  by  many  physicians  of  high  standing. 

We  read  of  his  travelling  up  and  down  the  country, 
lecturing  and  practising  and  making  a  great  commotion. 
He  asserted  that  the  remedy  was  especially  suited  to  local 
inflammations,  rheumatism,  and  pains  in  the  various  parts ; 
all  of  which  is  meaningless  now.  The  fame  of  the  man 
reached  Europe.  In  Copenhagen  a  juiy  of  respectable 
physicians  investigated  the  use  of  the  tractors  and  pub- 
lished an  elaborate  report  more  or  less  favorable;  indeed, 
they  named  the  practice  Perkinism.  The  popularity  of 
Perkinism  grew  for  several  years;  its  inventor  became 
rich,  and  died  at  the  height  of  his  prosperity.    In  1804  his 


282  AlEDICINE    IN    AMERICA. 

son  established  the  Perkinean  Institution  in  London,  with 
the  Right  Honorable  Lord  Rivers  as  President  and  Sir 
William  Barker  as  Vice-President.  After  the  death  of  its 
founder,  in  1810,  the  institution  sunk  into  neglect  and 
finally  disappeared. 

Now,  all  this  business  of  the  tractors,  which  is  ob- 
viously a  mere  matter  of  suggestive  therapeutics,  made  a 
ver}^  great  stir.  The  modus  operandi  of  the  cure  was  the 
subject  of  much  ingenious  theorizing,  and  endless  disputes 
and  a  great  variety  of  ponderous  philosophizing  were  ex- 
pended upon  the  shrewd  Connecticut  gentleman  and  his 
lucrative  invention ;  but  the  end  came,  as  it  was  bound  to 
do,  and  the  world  forgot  it,  as  it  has  forgotten  thousands 
of  similar  delusions  before  and  since.  The  episode  points 
a  moral ;  it  illustrates  the  times,  and  senses  to  show  why 
it  was  that  in  such  an  era  of  empiricism  and  popular  cre- 
dulity the  doctrine  of  homoeopathy,  which  soon  after 
arose,  should  have  gained  so  strong  a  hold  upon  a  weary, 
long-suffering,  and  maltreated  people. 

Much  has  already  been  told  of  the  efforts  made  by  com- 
petent men  in  the  profession  for  the  elevation  of  their 
calling  and  its  emancipation  from  such  conditions  as 
Elisha  Perkins  illustrates.  The  great  surgeons  did  much, 
but  more  than  to  all  others,  probably,  do  we  owe  it  to  the 
rare  medical  publicists  of  the  time  that  actual  advance- 
ment gradually  was  made.  Lentil  very  recent  years  med- 
ical literature  in  America  has  been  scanty  and  of  small 
circulation ;  American  text-books  have  been  rare,  and  ex- 
haustive treatises  almost  unknown.  For  many  years  most 
of  the  thought  and  expression  of  our  scientists  was  voiced 
by  means  of  the  medical  journals, — quarterlies  usually, — 
which  have  constantly  been  growing  in  number  and  im- 
portance. Our  first  journal  was  composed  of  selections 
and  translations  from  the  French  Journal  de  Medecine 
Militaire,  Paris,  1782  to  1788.  The  American  edition 
was  published  in  New  York  in  1790,  and  made  a  respect- 


XIX.  CENTURY.     EARLY    PHYSICIANS.     283 

able  octavo  of  one  hundred  and  twenty  pages.  Then 
there  was  that  admirable  Medical  Repository  of  Elihu  H. 
Smith,  S.  L.  Mitchell,  and  Edward  Miller,  which  ran  as 
a  quarterly  from  1797  to  1824,  and  proved  to  be  of  very 
great  service  to  the  good  cause.  Of  shorter  life,  but 
equally  important  while  it  lasted,  was  the  American  Med- 
ical and  Philosophical  Register.  It  was  in  existence  from 
1810  to  181 4,  and,  as  its  title  indicates,  was  not  devoted 
to  medicine  exclusively,  but  contained  other  miscellaneous 
papers  of  varying  scientific  interest;  indeed,  it  is  most 
agreeable  and  instructive  to-day.  The  chief  editor  of  this 
journal  was  David  Hosack,  one  of  the  most  enlightened, 
conspicuous,  and  able  men  in  New  York  a  hundred  years 
ago, — an  accomplished  physician,  a  surgeon  of  no  mean 
attainments,  and  a  strong,  vigorous,  public-spirited  citizen. 
His  name  appears  constantly  in  the  scanty  medical  litera- 
ture of  the  period,  and  his  career  calls  for  more  than  pass- 
ing notice;  indeed,  with  the  exception  of  Rush,  I  doubt 
whether  any  physician  of  that  time  was  better  known  to 
the  American  profession. 

David  Hosack  did  not  belong  to  the  Revolutionary  doc- 
tors. He  came  to  manhood  after  the  war  was  over,  and  is 
to  be  classed  with  the  new  and  progressive  generation  of 
which  Elihu  Smith  was  so  brilliant  an  exemplar.  He  was 
born  in  New  York  City  on  August  31,1 769,  the  very  year 
in  which  the  first  New  York  medical  degrees  were  con- 
ferred upon  Robert  Tucker  and  Samuel  Kissam. 

Hosack's  father,  Alexander,  a  cadet  of  good  Scotch 
family,  had  come  out  in  1758  as  an  artillery  officer  with 
Amherst,  and  after  the  French  war  had  settled  in  New 
York,  where  he  married  Jane  Arden  in  1768.  David 
Hosack  was  their  eldest  child,  and  was  thirteen  years  old 
at  the  close  of  the  Revolution.  He  was  a  bright,  intelli- 
gent boy  and  well  educated,  being  thoroughly  grounded, 
especially  in  the  Greek  and  Latin  classics,  the  reading  of 
which  he  kept  up  through  life;  but  he  was  not  precocious. 


284  MEDICINE    IN   AMERICA.  . 

He  was  seventeen  when  he  entered  Columbia  College, 
where  he  remained  but  two  years.  While  there  he  began 
the  study  of  medicine,  as  a  side  issue,  in  the  office  of  Rich- 
ard Bailey,  a  well-known  surgeon  of  the  day.  That  was 
in  the  summer  of  1 788,  and  Bailey  it  was  who,  as  we  may 
remember,  had  been  allowed  the  use  of  room  in  the  un- 
occupied New  York  Hospital  for  purposes  of  dissecting 
and  operating.  So  young  Hosack  was  concerned  in  the 
affair  of  the  "  Doctors'  Mob," — as  an  innocent  student 
only.  He  ran  away  with  the  rest  of  the  fraternity,  was 
well  hustled,  was  knocked  down  in  his  flight,  and  was 
only  saved  from  serious  injury  by  the  activity  of  a  kind 
neighbor  present,  who  picked  him  up  and  brought  him 
home. 

Hosack's  study  of  medicine  was  very  brief  at  that  time. 
He  was  a  thoughtful  young  fellow,  and,  being  determined 
to  be  a  doctor,  looked  about  for  the  best  means  of  be- 
coming a  good  one.  Profiting  by  the  written  words  of 
such  well-known  teachers  as  Morgan  and  Middleton,  he 
saw  that  a  thorough  preliminary  education  was  essential, 
and  as  the  Columbia  College  of  the  time  did  not  offer  what 
he  wanted,  he  went  to  Princeton  the  next  year,  passing,  by 
severe  study,  from  the  Sophomore  Class  in  New  York  to 
the  Senior  Class  at  the  New  Jersey  College,  whence  he 
was  graduated  Bachelor  of  Arts  in  the  autumn  of  1789. 

Immediately  on  leaving  college  Hosack  returned  to 
New  York  and  entered  seriously  upon  the  study  of  medi- 
cine under  former  teachers  of  the  old  Columbia  School. 
Bard  was  still  vigorous  and  useful  among  them ;  indeed, 
he  was  at  the  very  height  of  his  fame,  and  his  courses  in 
midwifery,  gynaecology,  and  pediatrics  were  great  attrac- 
tions to  New  York  students.  The  other  conspicuous 
teacher  was  Wright  Post,  who  lectured  on  anatomy  and 
physiology;  he  was  a  capable  surgeon  and  continued 
active  as  teacher  and  operator  well  into  the  next  centuiy. 
During  those  years,  from  the  close  of  the  war  to  1792, 


XIX.  CENTURY.     EARLY    PHYSICIANS.     285 

the  Columbia  School  did  not  exist,  even  in  name.  The  old 
professors  and  various  others  who  gave  medical  instruc- 
tion did  so  mostly  as  private  individuals,  though  they  util- 
ized the  New  York  Hospital  and  the  almshouse  for  clini- 
cal purposes.  At  the  best,  the  teaching  was  unformulated, 
and  after  a  year  of  it  Hosack  became  discouraged  with 
his  progress,  as  he  had  been  with  his  college  work  two 
years  before.  So  he  went  to  Philadelphia.  It  was  before 
the  days  of  Physick,  and  Rush  was  the  most  conspicuous 
man  there.  One  year  of  Philadelphia  sufficed  Hosack, 
and  he  received  the  M.D.  degree  in  1791,  at  the  age  of 
twenty-two. 

So  far  his  course  had  been  that  of  most  of  those  others 
whom  we  have  recorded,  but  now  he  determined  to  strike 
out  in  a  new  line.  He  was  not  yet  fired  with  the  high 
ideals  which  came  to  his  more  mature  years,  but  thought 
only  of  a  wife  and  money-making.  Accordingly,  he  mar- 
ried Catherine  Warner,  a  lady  of  Princeton,  whom  he  had 
known  during  his  college  course.  Then,  looking  about 
for  a  habitat,  he  resolved  to  settle  at  the  national  capital. 
This,  be  it  remembered,  was  during  Washington's  first 
administration,  while  the  city  bearing  his  name  was  as  yet 
unknown  to  geographers.  However,  wise  men  were  say- 
ing that  the  capital  would  be  established  at  Alexandria 
in  Virginia,  and  thither,  with  national  ambitions,  went 
Hosack  to  be  ready  for  the  new  regime.  It  was  an  inter- 
esting idea,  but  it  quickly  came  to  nothing.  The  existing 
field  was  small  and  after  a  year  its  prospects  seemed  un- 
propitious,  for  there  was  no  sign  of  the  expected  national 
movement.  Practice  was  ample,  but  fees  were  almost  nil. 
Here,  indeed,  was  a  sorry  outlook  for  a  gifted  young  man 
from  New  York,  with  a  wife  to  support  and  an  infant  son 
to  rear.  So  he  dropped  it  all,  wisely,  before  it  was  too 
late,  and  hurried  back  to  his  native  place.  It  is  an  inter- 
esting fact  about  Hosack  that,  the  Alexandria  experience 
excepted,  every  move  he  made  was  for  the  better;    and 


286  MEDICINE    IN    AMERICA. 

every  move  was  by  his  own  prompting,  without  advice 
from  father  or  friends. 

Arrived  in  New  York,  he  concluded  that  his  modest 
attainments  would  go  but  a  little  way  in  the  keen  rivalry 
of  that  growing  town,  so  he  determined  to  go  to  Europe 
to  learn  to  be  a  better  doctor. 

As  he  himself  writes,  "  Observing  the  distinction  which 
our  citizens  at  that  time  made  between  those  physicians 
who  had  been  educated  at  home  and  those  who  had  addi- 
tional instruction  from  the  universities  of  Europe,  and 
knowing  how  little  property  I  had  to  expect  from  my 
parents,  I  found  that  my  chief  dependence  was  upon  my 
own  industry  and  unceasing  attention  to  the  profession  I 
had  chosen  as  the  means  of  my  subsistence ;  my  ambition 
to  excel  in  my  profession  did  not  suffer  me  to  remain  in- 
sensible under  such  distinction."  So  the  courageous 
young  fellow,  with  a  very  thin  purse  and  a  very  sore 
heart,  left  wife  and  child  with  his  parents  and  started  off 
for  a  two  years'  sojourn  in  Europe.  Though  poor  in 
pocket,  he  had  many  good  friends,  who  took  pains  that  he 
should  make  his  way  into  an  agreeable  society  abroad. 
Accordingly  we  find  him,  on  the  night  of  his  arrival  in 
Liverpool,  installed  as  a  guest  at  the  house  of  William 
Renwick,  where  he  met  a  company  of  prominent  medical 
men  and  passed  an  evening  "  in  the  society  of  some  of  the 
choicest  spirits,"  among  others,  Robert  Burns.  "  After 
supper,  the  toddy  passing  freely  round,  he  gratified  us  by 
singing  one  of  his  own  songs."  For  the  young  man  that 
was  indeed  an  auspicious  introduction  to  the  home  of  his 
ancestors.  Then  to  Edinburgh,  and  the  instruction  of  the 
well-known  men  there,  of  whom  we  have  already  heard 
so  much. 

It  is  a  fact  characteristic  of  the  times,  that,  with  the 
exception  of  John  Warren  and  Elihu  Smith,  all  of  the 
better-known  American  doctors  enjoyed  privileges  of  edu- 
cation similar  to  those  of  Hosack,  and  as  we  follow  their 


XIX.  CENTURY.     EARLY    PHYSICIANS.     287 

early  lives  the  same  old  story  constantly  repeats  itself. 
Hosack  had  other  advantages,  however,  like  those  en- 
joyed by  Mott.  He  was  introduced  to  the  best  of  the 
kindly  Edinburgh  society,  which  made  the  most  of  bud- 
ding ability,  and  in  democratic  fashion  received  it  at  their 
comfortable  dinner-tables.  Great  lawyers,  doctors,  di- 
vines, and  writers  became  familiar  to  Hosack  in  the  Edin- 
burgh days,  and  the  broad  culture  which  he  there  attained 
made  of  him  a  most  delightful  and  valuable  man  in  after- 
life. Even  a  hundred  years  ago  some  feeble  specializing 
in  medicine  had  begun,  but  with  the  movement  Hosack 
was  not  in  entire  sympatliy.  He  believed  in  that  article 
of  our  modern  creed  which  teaches  that  a  man  should 
know  everything  about  something  and  something  about 
everything  else.  A  man  broad  in  wisdom,  he  came  to 
know  life,  which,  after  all,  is  the  summum  honum,  if  the 
knowledge  be  applied. 

After  a  year  in  Scotland, — a  year  spent  in  travel  as  well 
as  in  study, — Hosack  went  south  to  London  and  entered 
St.  Bartholomew's  Hospital  as  a  pupil  under  Sir  James 
Earle,  John  Hunter's  son-in-law.  Hunter  died  a  few 
months  after  this,  and  Hosack  records  the  fact  that  he  had 
the  satisfaction  of  attending  that  great  man's  funeral.  In 
London,  as  in  Edinburgh,  Hosack's  journal  is  a  record 
of  names  great  in  the  history  of  medicine.  Hunter  and 
Cline,  Cooper  and  Abernethy,  Babington  and  Smith, 
Banks  and  Marshall,  Pearson  and  Robertson  are  a  few 
of  those  whom  he  mentions  as  having  known  well.  He 
followed  general  medicine  and  surgery,  midwifery,  anat- 
omy, and  botany,  and  communicated  to  the  Royal  Society 
a  paper  entitled  "  Observations  on  Vision,"  for  which  he 
received  the  thanks  of  the  Society. 

Meantime,  the  young  man  had  not  forgotten  how  to 
play.  Desipere  in  loco  was  part  of  his  scheme,  in  spite  of 
separation  from  wife  and  home;  so  he  consoled  himself 
with  such  society  of  men  and  women  as  was  to  be  found, 


288  lAIEDICINE    IN    AMERICA. 

worshipping  at  the  shrine  of  the  goddesses,  Mrs.  Siddons, 
Airs.  Pope,  Miss  Farren,  Mrs.  Eden,  Mrs.  Jordan,  Miss 
De  Camp,  and  those  other  great  stage  lights  of  whom  our 
grandfathers  used  to  tell.  Those  were  famous  and  par- 
lous times.  George  Washington  presided  over  us,  Wil- 
liam Pitt  guided  Great  Britain,  the  Prince  Regent  was 
still  young,  the  poor  French  king  and  queen  were  having 
their  heads  cut  off,  and  young  America  abroad  was  learn- 
ing many  things. 

In  1794  Hosack  went  home,  and,  as  luck  would  have  it, 
found  abundant  material  for  practice  during  the  voyage  of 
nearly  eight  weeks.  Typhus  broke  out  and  raged  fiercely 
among  the  passengers,  and  Hosack,  being  the  only  doctor 
on  the  ship,  was  kept  busy  for  weeks  with  these  novel 
hospital  duties. 

Among  the  appreciative  passengers  was  a  Mr.  Law,  a 
wealthy  Englishman,  brother  to  Lord  Ellenborough.  This 
gentleman  conceived  a  veiy  high  opinion  of  young  Ho- 
sack, then  but  twenty-five  years  old,  and  on  their  landing 
in  New  York  he  made  it  his  business  to  push  his  protege's 
fortune  by  introducing  him  to  the  great  of  that  day.  Cu- 
riously enough,  Alexander  Hamilton  and  Aaron  Burr 
were  two  of  the  men  whom  Hosack  thus  met,  and  they 
both  thought  so  well  of  him  that  they  put  their  families 
under  his  care.  So  he  once  more  took  to  himself  his  wife, 
— his  son  had  died  during  his  absence, — secured  a  house, 
began  practice,  and  was  greatly  successful  from  the  out- 
set. In  that  first  year  his  professional  income  was  fifteen 
hundred  dollars, — a  very  large  sum  for  the  first  year, 
even  in  these  more  liberal  days. 

From  this  time  until  his  death,  thirty-six  years  later, 
Hosack  was  probably  the  best-known,  the  most  popular, 
the  most  accomplished,  and  the  most  useful  physician  in 
New  York.  Like  all  the  other  doctors  of  his  generation, 
his  best  energies  were  given  to  practice,  and  his  methods 
were  of  the  best ;    but  he  did  other  things  of  more  per- 


XIX.  CENTURY.     EARLY    PHYSICIANS.     289 

manent  value  to  the  community,  and  it  is  for  these  that 
he  deserves  recording. 

He  was  an  example,  by  reason  of  his  culture,  his  learn- 
ing, his  charity,  and  his  public  spirit,  in  an  age  when  those 
qualities  were  uncommon  in  the  American  profession ;  he 
was  a  teacher  and  a  promoter  of  good  medical  schools ;  he 
was  an  admirable  writer  and  a  courageous  and  untiring 
medical  reformer. 

Says  Herz,  "  A  man  can  be  neither  a  philosopher  nor  a 
physician  by  imitation  or  by  rules,  but  by  native  genius 
alone."  Hosack  seems  to  have  been  both  a  philosopher 
and  a  physician,  and  his  biographer  quotes  Vogel  as  say- 
ing, "  Perhaps  there  is  no  science  which  requires  so  pene- 
trating an  intellect,  so  much  talent  and  genius,  so  much 
force  of  mind,  so  much  acuteness  and  memory,  as  the 
science  of  medicine."  These  qualities  the  eulogist  applies 
to  Hosack. 

He  was  a  man  of  fine,  bold  appearance,  forceful  and 
kindly,  with  a  sonorous  voice,  keen  expression,  abundant 
sensibility,  and  contagious  sympathy.  He  seems  to  have 
been  without  any  jealousy  in  his  make-up;  for,  unlike 
many  other  eminent  physicians  before  and  since,  he  made 
his  intimates  among  his  equals  and  contemporaries  instead 
of  running  off  to  a  sympathetic  audience  of  hero-worship- 
ping juniors.  All  men  of  real  ability  were  worth  his  while 
and  became  his  friends. 

It  is  needless  to  say  that  he  was  a  tireless  worker — all 
the  men  who  succeed  in  medicine  are  that;  but,  like  his 
friend  and  contemporary,  J.  C.  Warren,  he  was  method- 
ical and  economized  his  time.  He  never  cut  his  lecture 
hour  and  he  never  came  late.  He  was  no  bore.  The  stu- 
dents seem  to  have  liked  to  hear  him.  He  was  opinionated 
and  outspoken,  and  in  those  days  of  many  theories  and  few 
text-books  there  was  abundant  opportunity  for  the  didac- 
tic lecturer  to  make  partisans  of  his  pupils  as  well  as  to 
instruct  them.     I  cannot  see  that  he  added  to  the  sum  of 

19 


290  MEDICINE    IN    AMERICA. 

human  knowledge  any  medical  thoughts  of  permanent 
value,  but  he  grouped  into  comprehensive  form  the  best 
thoughts  of  his  time,  and  saw  with  some  clearness  that 
science  must  rest  on  accurately  observed  and  recorded 
facts.  In  that  he  was  advancing  distinctly, — getting  be- 
yond the  class  of  Hoffmann  and  Cullen,  Boerhaave  and 
Brown,  and  even  of  his  friend  Rush,  who  could  never 
quite  clear  himself  from  the  fallacy  of  twisting  his  facts 
to  fit  his  theories.  Hosack  was  an  eloquent  champion  of 
theories,  but  his  theories  were  founded  on  physiology 
and  anatomy,  on  study  and  observation. 

In  1797,  three  years  after  his  return  from  London, 
when  but  twenty-eight  years  old,  he  was  given  a  professor- 
ship, being  appointed  to  succeed  William  Pitt  Smith  in 
the  chair  of  Materia  Medica  at  Columbia.  This  was  his 
first  distinctly  medical  teaching;  but  he  had  already,  for 
two  years,  held  the  chair  of  Botany,  and  now  he  continued 
as  incumbent  of  both. 

Those  were  the  fallow  days  of  the  Columbia  School. 
Medical  education  in  New  York  was  undergoing  read- 
justment; the  classes  were  small  and  the  course  ineffec- 
tive; indeed,  for  nineteen  years,  from  1792  to  181 1,  but 
thirty-four  students  were  graduated.  During  those  years 
Bard  and  Hosack  were  the  most  active  of  the  teachers, 
but  their  efforts  were  paralyzed  by  the  existing  conditions. 
It  was  at  this  period  that  Hosack  established  the  Elgin 
Botanical  Garden,  near  the  city,  on  the  road  between 
Bloomingdale  and  Kingsbridge.  It  was  an  enterprise  in- 
tended to  make  familiar  and  popularize  the  study  of  botany 
and  to  collect  into  one  place  the  native  plants  available. 
Eventually  the  garden  disappeared,  after  having  been  for 
many  years  consigned  to  the  authorities  of  the  College. 

In  1807,  on  the  founding  of  the  College  of  Physicians 
and  Surgeons  by  the  University  of  New  York,  Hosack 
was  made,  at  first.  Professor  of  Botany  and  Materia 
Medica  there;    soon  after  that  he  became  Professor  of 


XIX.  CENTURY.     EARLY    PHYSICIANS.     291 

Surgery  and  Midwifery;  and  finally,  in  181 1,  on  the 
reorganization  and  union  of  the  two  schools,  he  filled  the 
chair  of  the  Theory  and  Practice  of  Physic  and  Clinical 
Medicine. 

So  we  see  him  in  the  short  space  of  sixteen  years  hold- 
ing six  professorships  and  lecturing  upon  the  most  diverse 
subjects.  And  his  lectures  were  good,  if  one  may  judge 
by  tradition  and  his  voluminous  writings.  But  it  was 
medicine  proper  that  he  cared  for  most ;  the  earlier  fields 
of  his  endeavors  he  tilled  carefully,  but,  save  botany,  with- 
out special  enthusiasm,  and  w4iat  he  had  to  say  was 
largely  the  echo  of  his  excellent  foreign  teaching.  In 
clinical  medicine,  however,  he  made  a  great  impression  on 
his  classes,  and  his  diagnoses  were  brilliant,  if  not  always 
sure. 

Like  so  many  of  those  ancient  men,  quick  perception 
and  an  intuitive  tact  had  to  take  the  place  of  many  of 
our  modern  methods  of  precision ;  but  it  is  surprising  how 
just,  often,  were  the  conclusions  drawn. 

Though  Hosack  originated  no  new  surgical  procedures 
of  value,  he  was  an  excellent  surgeon  and  introduced  to 
America  several  good  things  from  Europe.  Up  to  this 
time  no  American  had  tied  the  femoral  artery  for  aneu- 
rism. Hosack  did  in  1808.  The  year  after  his  return 
from  Europe  he  introduced  the  method  of  treating  hydro- 
cele by  injection.  He  wrote  several  first-rate  papers  on 
diverse  surgical  subjects:  Glossitis,  Tetanus,  "Tic,"  An- 
thrax, Tumors  of  the  Breast.^ 

In  operations  he  insisted  upon  the  importance  of  leaving 
wounds  open  to  the  air  in  order  to  check  hemorrhage, — a 
method  advocated  later  by  Astley  Cooper  and  Dupuytren. 
Hosack's  surgical  work  was,  however,  of  no  special  value; 
his  heart  was  not  in  it;  and  after  1808  he  devoted  him- 
self, for  the  rest  of  his  life,  almost  exclusively  to  medi- 
cine. 


Medical  Essays,  vol.  ii. 


292  MEDICINE    IN    AMERICA. 

Though  controversial  in  his  medical  teaching,  Hosack 
was  not  bitter  or  discourteous.  Among  other  things,  he 
had  seen  much  of  yellow  fever,  and  had  convinced  him- 
self that  it  was  a  contagious  disease.  This  he  had  said  and 
written,  taking  sides  against  the  final  opinion  of  his  old 
master,  Rush.  The  controversy,  which  would  have  led 
to  enmity  between  most  physicians  of  that  time,  had  no 
such  effect  on  the  relations  of  these  two  distinguished 
men,  and  the  following  cordial  letters  from  Rush  are 
pleasant  evidences  of  professional  amenities,  w^hile  they 
throw  an  interesting  side  light  on  the  ethics  of  the  time. 

"  Philadelphia^  August  15th,  1810. 
"  Dear  Sir  : — 

"  I  shall  this  day  put  into  the  hands  of  Mr.  Humph- 
reys the  Spanish  translation  of  my  account  of  the  yellow 
fever  in  1793,  ^.nd  a  manuscript  copy  of  Dr.  Mitchell's 
letter  on  the  yellow  fever,  accompanied  with  a  letter  from 
Governor  Colden  upon  the  same  subject.  They  were 
found  among  the  papers  of  my  old  master,  the  late  Dr. 
Redman,  and  were  given  to  me  by  his  daughter  since  his 
death.  The  copy  from  which  Dr.  Coxe  printed  an  extract 
of  Dr.  Mitchell's  letter  perished  in  the  printing  office  to 
which  it  was  sent  for  publication.  I  beg  you  would  return 
the  copy  herewith  sent  with  the  Spanish  translation,  which 
accompanies  it.  I  thank  you  for  the  liberal  manner  in 
which  you  have  dissented  from  my  opinions  upon  the  sub- 
ject of  your  present  inquiries.  In  the  laudable  attempts 
which  are  now  making  to  improve  the  condition  of  man- 
kind, I  wish  a  society  could  be  formed  to  Jmmani^e  phy- 
sicians. General  Lee  once  said,  *  Oh !  that  I  were  a  dog, 
that  I  might  not  call  man  a  brother!'  With  how  much 
more  reason  might  I  say,  *  Oh !  that  I  were  a  member  of 
any  other  profession  than  that  of  medicine,  that  I  might 
not  call  physicians  my  brethren !' 

"  I  have  lately  treated  a  case  of  anthrax  with  bark  and 
other  cordial  remedies,  agreeably  to  your  practice,  with 


XIX.  CENTURY.     EARLY    PHYSICIANS.     293 

success.  The  inflammatory  action  of  the  blood-vessels, 
in  that  disease,  partakes  too  much  of  the  soap  bubble  to 
admit  of  the  common  antiphlogistic  remedies. 

"  Our  city  is  unusually  healthy.  My  wife  and  daughter 
are  now  in  Jersey.  Were  they  here,  I  am  sure  they  would 
unite  in  cordial  respects  to  you  and  your  excellent  lady, 
with,  dear  sir, 

"  Yours  sincerely, 

"Benjn.  Rush.'' 

"June  20th,  1812. 

"  My  dear  Friend  : — 

"  Our  Philosophical  Society  meets  but  once  a  month 
in  summer.  They  met  last  evening.  Their  next  meeting 
will  be  on  the  third  Friday  of  next  month,  which  is,  I 
think,  on  the  1 7th  of  the  month ;  on  which  day,  or  before 
it,  I  shall  expect  to  have  the  pleasure  of  taking  you  by  the 
hand  as  my  guest.  All  my  family  unite  with  me  in  re- 
questing you  to  make  our  house  your  home  while  you 
remain  in  Philadelphia.  Let  us  show  the  world  that  a 
difference  of  opinion  upon  medical  subjects  is  not  incom- 
patible with  medical  friendships;  and  in  so  doing,  let  us 
throw  the  whole  odium  of  the  hostility  of  physicians  to 
each  other  upon  their  competition  for  business  and  money. 
Alas !  while  merchants,  mechanics,  lawyers,  and  the  clergy- 
live  in  friendly  intercourse  with  each  other,  and  while  even 
the  brutes  are  gregarious,  and 

'  Devil  with  devil  firm  concord  holds,' 

to  use  the  words  of  Milton,  physicians,  in  all  ages  and 
countries,  riot  upon  each  others'  characters !  How  shall 
we  resolve  this  problem  in  morals  ? 

"  With  love  to  Mrs.  Hosack  and  Miss  Mary,  in  which 
all  my  family  join, 

'T  am,  dear  sir, 
"  Your  friend  and  brother  in  the  republic  of  medicine, 

"  Benjn.  Rush.'' 


294  MEDICINE    IN    AMERICA. 

In  one  of  his  introductory  discourses  ^  Hosack  lays 
down  for  his  students  his  own  estimate  of  the  nature  of 
medical  studies  and  the  requirements  for  the  pursuit  of 
medicine.  The  practice  of  physic  must  be  preceded  by 
an  attainment  of  principles,  through  "  accurate  observa- 
tion, judicious  experiment,  and  cautious  induction  from 
the  facts  which  they  present,"  and  he  dwells  at  length  on 
the  great  importance  of  clinical  experience.  "  The  dis- 
cernment of  a  disease  is  only  to  be  acquired  by  long  and 
habitual  observation  at  the  bedside  of  the  sick,  for  it  fre- 
quently happens  that  not  only  the  symptoms,  but  the  causes 
of  disease,  are  so  concealed  that  they  escape  the  observa- 
tion both  of  the  patient  and  the  bystander ;  and,  even  by 
the  physician,  are  only  to  be  discovered  by  habitual  atten- 
tion to  the  phenomena  of  health,  as  well  as  the  symptoms 
of  disease  .  .  .  though  books  of  practice  may  furnish  the 
description  of  the  symptoms  of  disease  and  faithfully  de- 
lineate the  more  prominent  features  by  which  they  are 
characterized,  there  are  certain  nicer  shades  of  discrimini- 
nation  which  frequent  converse  with  the  sick  can  alone 
detect:  for  diseases,  like  plants  and  animals,  have  their 
peculiarities  of  character  which  no  system  of  nosology  will 
supply,  no  description,  however  voluminous  or  minute, 
can  impart,  which  no  medical  Lavater  has  yet  delineated 
and  with  which  practice  alone  can  make  us  acquainted." 

He  then  goes  on  to  give  a  pleasant  account  of  the 
growth  of  medicine,  and,  beginning  with  Hippocrates,  to 
place  our  medical  heroes  in  their  appropriate  niches.  He 
closes  with  a  eulogy  of  Rush,  who,  with  Sydenham  and 
Boerhaave,  is  made  to  shine  as  one  of  the  bright  particular 
stars. 

What  one  feels  in  reading  Hosack's  works  is  not  only 
his  acumen  and  firm  grasp  of  each  particular  subject,  but 
his  broad  humanity  and  his  philosophic  view  of  medicine, 


American  Medical  and  Pliilosopliical  Register,  vol.  iv.  p.  305. 


XIX.  CENTURY.     EARLY    PHYSICIANS.     295 

as  of  life.  Though  an  accurate  student,  he  beheved 
"  science  for  science's  sake"  to  be  an  untenable  proposi- 
tion ;  that,  in  the  long  run,  knowledge  that  leads  nowhere 
is  but  half  knowledge;  and  that  a  thorough  knowledge 
of  one  branch  mid  of  no  more  is  not  full  knowledge. 

In  such  thoughts  he  was  generations  ahead  of  his  time, 
and  he  would  doubtless  have  agreed  with  those  among  us 
who  to-day  believe  that  strict  specialism  leads  to  mental 
indolence;  that  the  man  who  confines  his  interest  to  his 
own  little  daily  round  grows  ineffective  even  for  the  task 
before  him. 

Hosack  was  known  as  an  eminent  citizen  as  well  as 
a  popular  teacher  and  a  good  doctor.  He  was  what 
we  flippant  moderns  would  call  very  much  of  a  good 
fellow.  Certainly  good  fellows  were  his  warm  friends, 
and  it  is  pleasant  to  read  of  Alexander  Hamilton's  devo- 
tion to  him.  Aaron  Burr  also  was  his  faithful  patient, 
though  on  that  side  there  was  no  special  intimacy.  For- 
tunately, science  disregards  politics,  else  one  scarcely 
could  tolerate  the  friend  of  Hamilton  caring  for  Burr 
and  dedicating  volumes  to  such  politically  surprising  per- 
sons as  Brockholst  Livingston  and  De  Witt  Clinton.  The 
ingenuous  frankness  of  the  address  to  the  last  is  refresh- 
ing :  "  The  editors  are  not  influenced  by  considerations 
of  a  political  nature — in  that  respect  they  have  no  hesita- 
tion to  avow  their  allegiance  to  other  principles  than  those 
which  you  profess — but  they  offer  a  tribute  to  the  talents 
and  liberality  which  you  have  manifested  in  promoting 
the  interests  of  science." 

To  none  of  these  men  was  Hosack  more  attached  than 
to  Hamilton,  his  early  patron  and  friend  while  the  latter 
lived.  Hamilton  felt  for  Hosack  the  grateful  devotion 
with  which  the  old-time  doctors  managed  to  inspire  their 
patients  for  the  life  of  a  child  saved,  and  the  last  service 
which  Hosack  rendered  him  was  on  the  field  in  the  duel 
with  Burr. 


296  MEDICINE    IN   AMERICA. 

Hosack's  son/  who  wrote  a  dreary  sketch  of  his  pro- 
genitor, says  that  his  father  possessed  and  desen-ed  the 
confidence  of  the  community  not  only  for  his  abihty,  but 
for  his  urbanity  of  manner.  Now,  the  "  urbanity"  of  the 
younger  Hosack,  hke  the  "  sensibihty"  of  Jane  Austen, 
is  a  quahty  httle  esteemed  by  the  modern  world;  but, 
disregarding  those  pleasant  old  adjectives,  it  is  certain 
that  folk  did  like  David  Hosack,  and  that,  for  the  credit 
of  medicine,  he  was  the  right  man  in  the  right  place. 
He  thought  well  of  men  and  women ;  he  was  unwearied 
in  suffering  their  prolix  tales;  he  had  abundant  genuine 
human  sympathy;  he  was  charitable  towards  all  where 
charity  was  due ;  he  was  outspoken  betimes ;  he  was  capa- 
ble of  a  fine,  impetuous  indignation  on  occasion;  he  led 
a  clean  life;   and  he  was  beheld  of  all  men. 


*  Hosack's  son  published  the  following  account  of  the  composing 
of  Washington's  Farewell  Address  and  Hamilton's  concern  with  it: 

"  In  looking  over  my  father's  correspondence,  I  found  the  copy  of 
a  letter  in  his  handwriting,  addressed  to  his  friend  Dr.  James,  of 
Philadelphia,  in  reply  to  one  requesting  information  from  him  as 
to  the  authorship  of  the  '  Farewell  Address  of  Washington,'  which 
had  been  attributed  to  General  Hamilton.  Dr.  James  had  been  in- 
duced to  seek  this  information  from  my  father,  from  the  well-known 
intimacy  existing  between  him  and  General  Hamilton,  and,  as  every 
fact  concerning  the  history  of  these  two  distinguished  personages — 
General  Washington  and  General  Hamilton — will  be  of  the  greatest 
interest  to  future  ages,  I  deem  it  important  to  give  publicity  to  it 
here,  by  subjoining  a  copy  of  it. 

"  '  My  dear  Friend  : — 

"  '  I  am  gratified  by  your  communication  of  the  6th  inst.,  to  learn 
that  Mr.  Rawle  has  received  satisfactory  information  from  Governor 
Jay  upon  the  subject  of  General  Washington's  Farewell  Address, 
and  which  I  believe  you  will  find  to  correspond  with  the  statement 
I  gave  you  verbally  when  I  was  last  in  Philadelphia.  As  I  then 
stated  to  j'ou,  I  happened  to  be  at  the  house  of  General  Hamilton, 
making  a  professional  visit  to  one  of  his  family,  on  the  morning  he 
received  from  General  Washington  the  outline  of  his  contemplated 
address,  written  upon  several  sheets  of  foolscap  paper,  and  request- 
ing General  Hamilton's  opinion  and  views  relative  to  that  subject. 
I  shall  never  forget  the  gratification  displayed  by  the  General  upon 
receiving  this  high  compliment  frojn  his  great  chief.     I  was  after- 


XIX.  CENTURY.     EARLY    PHYSICIANS.     297 

His  interests,  like  those  of  Rush,  Fothergill,  and  J.  C. 
Warren,  were  numerous;  he  founded  a  humane  society, 
he  helped  to  remodel  the  Dispensary;  he  was  an  early 
advocate  of  vaccination ;  and  he  urged  vigorously  the 
establishment  of  municipal  contagious  hospitals,  national 
quarantine  regulations,  and  a  proper  system  of  city  drain- 
age.^ He  pronounced  a  eulogy  on  his  deceased  friend, 
De  Witt  Clinton,  for  which  he  was  warmly  thanked 
by  Kent,  Story,  and  Marshall.  He  kept  open  house 
in  a  fashion  lavish  for  the  time,  and  he  gave  entertain- 
ments of  the  kind  known  to  our  ancestors  as  "  Conversa- 
ziones." Such  diverse  characters  as  the  Abbe  Correa, 
Michaux,  Sir  John  Franklin,  Dr.  Richardson,  Captain 
Sabine,  Captain  Basil  Hall  (our  contemptuous  critic), 
Washington  Irving,  J.  Fenimore  Cooper,  Bryant,  Hal- 


wards  informed  by  my  friend,  the  late  Nathaniel  Pendleton,  one  of 
the  executors  of  General  Hamilton,  who  at  the  time  possessed  some 
of  the  General's  papers,  that  he  had  seen  the  valedictory  address  in 
the  handwriting  of  General  Hamilton,  by  which  it  appears  that  the 
suggestions  and  alterations  which  he  had  made  were  so  numerous 
and  so  extensive  as  rendered  it  necessary  for  him  to  transcribe  the 
whole.  This  fact,  I  believe,  has  been  the  origin  of  the  report  that 
the  whole  production  had  been  originally  written  by  General  Ham- 
ilton. 

" '  Any  person  acquainted  with  General  Washington  and  the  pro- 
ductions of  his  pen,  must  have  known  that  he  was  distinguished  for 
those  powers  of  mind,  that  correctness  of  judgment,  that  decision 
and  pride  of  character,  that  original  thinking  and  readiness  in  com- 
mitting his  thoughts  to  paper,  and  in  which  his  simplicity  and  neat- 
ness of  composition  may  almost  bear  comparison  with  the  most 
classic  writers  of  the  age,  that  he  would  not  have  committed  a  sub- 
ject of  that  magnitude  exclusively  to  any  man  living.  But  while 
the  same  ability  would  prompt  him  to  execute  the  outline,  his  high 
respect  for  and  confidence  in  the  distinguished  abilities  of  his  friend 
Hamilton,  long  a  confidential  member  of  his  family,  would  induce 
him  to  avail  himself  of  so  important  a  document  as  the  legacy  he 
has  left  to  his  beloved  country,  and  indeed  to  the  world. 
"  '  I  am,  my  dear  friend, 

"  '  Very  truly  yours, 

"  '  David  Hosack.'  " 

"Medical  Police,  pp.  30  and  31,  in  Medical  Essays,  vol.  ii. 


298  MEDICINE    IN    AAIERICA. 

leek,  Chancellor  Kent,  Emmet,  Silliman,  and  many  others 
are  said  to  have  crowded  his  drawing-rooms.  It  must 
have  been  an  interesting  compan}^;  they  all  liked  their 
host  and  did  not  interfere  with  his  busy  life. 

Hosack  was  three  times  married.  We  have  seen  the 
end  of  his  young  first  wife  and  son.  WHien  but  twenty- 
eight  years  old  he  married  again, — Mary  Eddy, — and 
the  two  had  nine  children,  five  of  whom  survived  him. 
Then,  late  in  life,  when  he  found  himself  again  bereft, 
he  married  for  his  comfort  Magdalena  Coster,  an  amiable 
widow. 

With  all  his  activities,  his  generosity,  and  his  heav}' 
expenses,  Hosack  managed  to  accumulate  property,  for 
he  was  a  good  man  of  business.  In  his  case  the  saying 
that  "  professional  men  live  well,  work  hard,  and  die 
poor"  was  not  altogether  true,  for  he  charged  well  for 
his  services  where  charges  were  proper,  and  at  sixty  he 
was  able  to  retire  to  a  comfortable  country  place  on  the 
Hudson.  There  he  remained  mostly  for  the  last  six  years 
of  his  life,  and  he  died,  still  comparatively  young  and 
vigorous,  in  1835,  at  the  age  of  sixty-six. 

Contemporary  with  Hosack,  though  some  seven  years 
his  senior,  was  Nathan  Smith,  of  New  England.  In 
his  way  an  even  stronger  character  than  the  former,  he 
rather  suggests  that  vigorous  pioneer  of  the  West,  Daniel 
Drake. 

Smith  was  the  son  of  a  small  farmer,  and  was  born  in 
Rehoboth,  Massachusetts,  on  September  30,  1762.  While 
he  was  an  infant  his  parents  emigrated  to  Vermont,  then 
in  the  wilds,  but  recently  relieved  of  the  great  French  in- 
vasion which  ended  with  the  capture  of  Ticonderoga  by 
Amherst  in  1759.  In  the  same  year  came  the  fall  of  Que- 
bec and  the  death  of  Wolfe,  followed  four  years  later  by 
the  Peace  of  Paris  and  the  end  of  the  old  French  War. 
Immediately  after  the  peace,  when  the  parents  of  Smith 
settled  at  Chester,  in  the  southern  part  of  Vermont,  that 


XIX.  CENTURY.     EARLY    PHYSICIANS. 


299 


region  was  still  a  wilderness,  and  the  people  were  fron- 
tiersmen as  much  as  were  their  kinsfolk  of  the  Ohio  Val- 
ley. The  primeval  forest  still  covered  the  hills,  the  clear- 
ings were  few  and  distant,  wild  creatures  abounded  in 
the  woods,  and  the  Indians  of  whom  Cooper  tells  trapped 
there  zealously  as  the  fancy  took  them. 

It  was  a  stimulating  life  for  the  growing  lad,  and  when 
he  was  but  fifteen  years  old  there  came  into  it  that  fear- 
some expedition  of  the  luckless  Burgoyne  and  the  famous 
American  defeat  of  arms,  when  Arnold  won  laurels  for 
Gates  at  Saratoga.  Not  long  after  this  young  Smith 
himself  saw  some  desultory  service  as  a  volunteer  in  that 
rather  useless  body,  the  State  militia.  He  was  stationed 
with  his  command  on  the  Canadian  border,  and  led  an 
active  existence  for  a  few  months,  but  was  never  in  any 
immediate  danger  save  once,  when  a  hostile  Indian  who 
was  a  poor  marksman  shot  at  him  from  behind  a  tree. 
The  bullet  did  not  find  him.  One  of  his  biographers,  with 
singular  lack  of  humor,  remarks  in  parenthesis  that  "  he 
frequently  alluded  to  hardships  and  privations  which  he 
endured,  while  encamped  in  the  wilderness,  with  few  of 
the  necessities  and  none  of  the  conveniences  of  life." 

Smith's  son,  Nathan  R.  Smith,  the  distinguished  Pro- 
fessor of  Surgery  in  the  University  of  Maryland,  says 
of  his  father  that  in  early  life  he  showed  no  leaning 
towards  science,  nor  thought  beyond  the  rough  existence 
which  his  father  had  always  known.  His  education  was 
defective,  and  went  no  further  than  enabling  him  to  teach 
the  rudiments  in  a  remote  country  school.  Even  the  loyal 
son  failed  to  appreciate  the  incalculable  value  of  that  early 
life  in  the  woods,  the  best  possible  training  for  an  active- 
minded  lad.  It  was  there,  in  the  things  of  nature,  the 
craft  of  the  Indians,  the  habits  of  the  wild  creatures,  the 
signs  of  the  seasons  and  the  weather,  the  growth  of  trees, 
crops,  and  flowers,  and  the  thousand  other  fascinating 
tokens  which  appear  to  him  who  waits  open-eyed  and 


300  MEDICINE    IN   AMERICA. 

receptive, — it  was  there  that  he  acquired  that  wonderful 
faciHty  of  observation  and  deduction  for  which  lie  was 
famous  in  after-life. 

Smith  was  twenty-four  years  old  when,  by  chance  of 
frontier  existence,  he  saw  a  surgical  operation  at  the 
hands  of  one  of  those  rare  competent  men  whom  the 
rough  country  sometimes  knew.  The  surgeon  was  Josiah 
Goodhue,  of  Putney,  Vermont.  Promptly,  Smith  was 
fired  with  the  ambition  to  know  more  of  the  mysteries 
of  which  he  had  had  a  glimpse,  and  he  applied  to  Good- 
hue to  make  a  doctor  of  him.  Most  fortunately  for  him 
and  for  us,  the  elder  man  declined  the  task  unless  Smith 
would  first  push  his  education  so  far  as  to  qualify  for 
the  Freshman  Class  at  Plarvard  College.  He  thought 
that  that  would  be  the  end  of  it,  but  a  year  later  Smith 
appeared  with  the  condition  fulfilled.  Goodhue  was  as 
good  as  his  word;  he  took  the  young  man  as  a  pupil, 
held  him  sharply  to  his  task  for  three  years,  and  turned 
him  out  at  the  end,  in  strong,  rough  fashion,  qualified 
for  the  country  doctor's  life.  Then  Smith  settled  himself 
at  practice  in  the  town  of  Cornish,  across  the  Connecticut 
River  from  Windsor,  Vermont. 

From  the  outset  he  was  a  thinker,  and  we  know  that 
he  was  a  critical  observer.  Those  qualities  led  him  to 
two  conclusions:  that  he  himself  knew  little  of  the 
science  of  medicine,  and  that  the  doctors  about  him  knew 
still  less.  But  the  crassness  and  ignorance  did  not  appall 
him.  He  resolved,  with  a  tenacity  which  increased 
through  life,  to  better  all  that.  He  saw  that  the  ineffi- 
ciency of  his  fellows  was  due  to  lack  of  opportunity,  not 
to  lack  of  brains.  They  were  smart  enough,  as  our  New 
England  people  say. 

At  that  time,  be  it  remembered,  there  were  but  three 
medical  schools  in  America,  the  Pennsylvania  School,  the 
moribund  New  York  School,  and  the  infant  Harvard 
School.     Smith's  first  move  was  to  visit  the  Harvard 


XIX.  CENTURY.     EARLY    PHYSICIANS.     301 

School  for  a  term  and  extract  what  he  could  from  it. 
He  had  been  practising  some  two  years  in  Cornish  and 
realized  fully  wherein  he  was  weak,  so  that  the  experi- 
ence at  Harvard  meant  more  to  him  than  to  most.  He 
remained  there  one  year,  highly  regarded  by  his  teachers, 
especially  by  John  Warren,  the  enthusiastic  Professor  of 
Surgery,  and  he  was  graduated  Bachelor  of  Medicine  in 
1790,  reading  at  the  Commencement  exercises  a  disser- 
tation on  "  The  Circulation  of  the  Blood."  He  then  re- 
turned to  Cornish  to  practise  and  to  scheme  farther  im- 
provements. 

As  respected  qualified  doctors,  the  backwoods  districts 
of  New  Hampshire  and  Vermont  were  in  the  deplorable 
state  common  to  the  whole  country,  and  Smith  was 
prompted  to  work  for  the  reforms  which  were  absorb- 
ing those  others  of  whom  we  have  read :  Morgan,  Bard, 
Rush,  Hosack,  Warren,  and  the  like.  Schools  were  few, 
distances  to  travel  very  great,  and  money  was  scarce 
everywhere.  A  new  government  was  in  process  of  estab- 
lishment under  the  direction  of  Washington,  and  Morris 
and  Hamilton  were  struggling  with  the  question  of  our 
national  finances.  It  was  a  poor  time  for  the  promoting 
of  educational  enterprises,  but  Smith  determined  to  try 
his  hand  at  it.  If  he  could  start  a  little  school  in  North- 
ern New  England  for  the  economical  training  of  country 
doctors,  the  leaven  would  work  in  time;  men  with  some 
degree  of  equipment  would  gradually  be  sifted  through 
the  community,  and  in  the  resulting  struggle  the  fittest 
would  survive  and  the  old-time  incompetents  eventually 
die  off  or  be  pushed  to  the  wall. 

Wisely,  Smith  saw  that  a  private  school,  such  as  he 
might  conduct,  would  never  succeed  at  that  time  and 
place,  so  he  turned  naturally  to  the  near-by  College  of 
Dartmouth,  and,  under  its  shelter  and  the  warm  encour- 
agement of  President  Wheelock,  established  his  Medical 
Institute. 


302  MEDICINE    IN   AMERICA. 

When  it  came  to  working  out  the  details  of  his  plan, 
Smith  found  tliat  he  himself  was  the  only  available 
teacher;  and,  rising  to  the  task  and  his  opportunities,  he 
straightway  undertook  all  the  branches.  Practically  he 
assumed  the  chairs  of  Medicine,  Surgery,  Anatomy, 
Therapeutics,  Botany,  Physiology,  and  Chemistry.  He 
had  now  been  practising  some  six  years  in  Cornish,  and 
had  struggled  into  the  possession  of  a  small  sum  of 
money.  When  he  saw  the  position  in  which  his  new 
duties  had  placed  him,  he  without  hesitation  threw  up 
his  practice,  postponed  his  Medical  Institute  for  a  year, 
pocketed  his  savings,  and  sailed  for  Europe  for  study, 
the  better  to  qualify  for  his  coming  work.  It  was  in 
December,  1796,  that  he  went  abroad,  and  he  landed  in 
Glasgow  early  in  the  following  January. 

His  experiences  in  Europe  were  the  usual  ones;  lec- 
tures and  hospital  clinics  at  Glasgow  were  followed  by 
similar  work  at  Edinburgh,  under  Monro  and  Black. 
Then  in  April  he  went  up  to  London  to  see  the  prac- 
tice there.  His  stay  in  Great  Britain  lasted  only  about 
six  months  altogether;  but  he  went  there  a  veteran 
practitioner  with  definite  aims  in  view,  and,  having  at- 
tained them,  hastened  home  to  New  Hampshire  and  Presi- 
dent Wheelock.  Soon  after  leaving  London,  through  the 
interest  of  Lettsom,  he  was  elected  a  corresponding  mem- 
ber of  the  London  Medical  Society,  and  that,  too,  al- 
though he  had  not  yet  obtained  the  degree  of  Doctor  of 
Medicine. 

While  in  Edinburgh  he  had  not  been  unmindful  of  his 
own  infant  school,  but  had  sent  out  consignments  of  medi- 
cal books  for  the  foundation  of  a  library  there.  From 
London,  too,  he  had  sent  chemical,  anatomical,  and  sur- 
gical apparatus,  though  there  was  no  kindly  Fothergill 
to  help  him;  so  that,  on  his  return  to  Dartmouth  and 
the  opening  of  the  school  early  in  1798,  there  were  in 
hand  some  few  necessaries  with  which  to  begin  his  scien- 


XIX.  CENTURY.     EARLY    PHYSICIANS.     303 

tific  housekeeping.  At  the  following  Commencement  he 
was  given  his  first  reward,  the  doctor's  degree  from  Dart- 
mouth. 

For  the  next  twelve  years,  or  until  he  was  iovty-tight 
years  old,  he  labored  zealously  in  his  new  field,  and  he 
labored  alone.  It  was  a  great  feat.  He  knew  all  the 
students,  he  gave  all  the  lectures,  he  quizzed  all  the  classes, 
he  held  all  the  examinations,  and  he  recommended  for 
the  degree.  He  was  demonstrator,  surgeon,  physiologist, 
chemist,  and  instructor  in  internal  medicine.  And  he  did 
all  these  things  well,  as  his  writings  and  his  accomplish- 
ments show. 

At  the  outset  he  had  about  twenty  students  under  him, 
but  these  soon  increased,  until  towards  the  end  of  the 
period  some  sixty  men  attended  his  lectures.  His  instruc- 
tion was  pungent  and  practical.  As  he  himself  says,  he 
had  no  time  to  be  a  bookman.  Through  life  his  knowl- 
edge of  medical  literature  was  small;  but  his  experience 
was  enormous;  his  observation  instant,  keen,  and  accu- 
rate; his  deductions  sound  and  logical;  his  expositions 
convincing.  He  was  full  of  expedient  and  common  sense. 
ver\'  modem  in  his  way  of  looking  at  disease,  never  in- 
fluenced by  dogma,  sparing  in  his  use  of  drugs,  and  an 
early  exponent  of  the  growing  belief  in  the  self-limited 
character  of  many  diseases.  With  all  this,  one  thinks 
of  Nathan  Smith  as  the  ideal  country  doctor:  strong, 
untiring,  devoted;  travelling  a  great  circuit  of  hundreds 
of  miles  in  that  wild,  rough  northern  land;  a  faithful 
ser^^ant  to  his  people,  a  tower  of  strength  to  a  hundred 
consultants. 

Dartmouth  carries  on  her  rolls  a  splendid  list  of  alumni. 
but  to  most  of  the  world  two  names  are  the  conspicuous 
ones :  Nathan  Smith  and  Daniel  \A''eb5ter.  There  was 
twenty  years'  difference  in  their  ages,  but  the  two  men 
worked  together  at  Hanover  in  common  during  three 
years, — the  elder  mature  man  as  teacher,  the  younger  as 


304 


MEDICINE    IN    AMERICA. 


student, — until  1801,  when  Webster  was  graduated;  and 
a  warm  appreciation  and  friendship  was  there  estabhshed 
which  it  is  pleasant  to  think  lasted  through  life. 

In  1810  Smith's  teaching  labors  were  somewhat  light- 
ened by  the  accession  to  the  little  faculty  of  Cyrus  Per- 
kins, who  was  appointed  to  the  chair  of  Anatomy,  which 
he  held  until  called  to  New  York  several  years  later. 

So  the  good  work  went  on  until  a  strong,  permanent 
school  had  been  built  up,  the  profession  of  Northern  New 
England  led  out  of  the  wilderness  of  ignorance,  and 
Smith's  great  abilities  recognized  and  admired  through- 
out the  land. 

In  181 3  the  inevitable  time  came  when  a  wider  com- 
munity claimed  him.  In  that  year  Yale  College  was 
founding  her  Medical  School,  and  Smith  was  called  to  a 
chair  in  the  New  Haven  Institution.  He  had  founded 
and  developed  one  school  well,  here  was  his  opportunity 
to  repeat  the  feat.  So  he  yielded  to  the  demand  and  went 
to  Yale  as  Professor  of  the  Theory  and  Practice  of 
Physic  and  Surgery.  There  again  he  took  up  his  busy 
round, — teacher,  practitioner,  and  consultant, — and  there 
he  labored  sixteen  years  until  his  death,  in  1829. 

During  those  years  some  of  his  excursions  took  him 
very  far  from  home.  While  continuing  his  lectures  in 
New  Haven  he  gave  a  course  at  Dartmouth,  where  his 
old  friends  still  claimed  him ;  he  also  gave  lectures  at  the 
Vermont  University  in  Burlington,  and  when  the  Medical 
School  of  Bowdoin  was  opened,  in  1821,  he  assumed 
charge  of  it,  conducted  it  successfully  for  two  years,  and 
gave  it  an  impetus  for  which  it  is  still  grateful. 

Nathan  Smith  was  the  most  famous,  perhaps  the  only 
famous  physician  and  surgeon  combined  that  we  have 
produced,  for  his  fame  lies  in  both  fields.  He  wrote  a 
treatise  on  typhus  fever,  or  typhoid,  as  we  should  more 
properly  call  it,  which  has  become  a  classic  and  should 
be  read  to-day  by  every  medical  student.     The  style  is 


XIX.  CENTURY.     EARLY    PHYSICIANS.     305 

delightful  and  homely.  The  essay  is  full  of  honest  in- 
formation and  shrewd  advice. 

He  draws  a  picture  of  the  disease  which  no  student 
could  forget,  and  he  does  it  all  without  recording  a 
temperature,  for  the  clinical  thermometer  was  then  un- 
known. But  the  insidious  onset,  the  beginning  discom- 
fort, the  malaise,  the  headache,  the  backache,  the  sore- 
ness, the  lassitude,  the  loss  of  time-sense,  the  increasing 
delirium,  the  various  manifestations  connected  with  the 
excretory  organs,  the  occasional  hemorrhage,  the  sudden 
collapse,  the  slow  convalescence,  the  relapse,  the  return 
to  health,  the  enormous  appetite,  and  the  gain  in  weight 
— of  all  these  things  he  tells  most  graphically,  but  in 
few  words.  And  then  the  treatment — truly  we  have  im- 
proved little  on  what  that  old  man  did.  He  fed  the 
patient  largely  on  milk,  he  gave  him  to  drink  copiously 
of  clear  water,  he  stimulated  him  at  times,  he  withheld 
strong  drugs,  he  kept  him  in  a  cool,  well-ventilated  room, 
and  he  drenched  him  frequently  with  cold  water  when  the 
fever  ran  high.     It  is  a  refreshing  tale. 

Not  content  with  saying  and  writing  these  things  on 
typhoid,  Smith  must  needs  turn  his  attention  to  ovari- 
otomy. In  four  short  pages  he  tells  modestly  of  an  oper- 
ation performed  by  him,  and  leaves  his  son  to  add  a  brief 
foot-note.  Yet  it  was  a  very  remarkable  pioneer  deed. 
It  was  done  in  1821,  twelve  years  after  McDowell  had 
established  the  operation  in  the  backwoods,  but  Smith 
was  ignorant  of  his  predecessor. 

His  patient  was  a  woman  thirty-three  years  of  age,  who 
had  noticed  an  abdominal  tumor  about  seven  years.  It 
was  said  to  have  burst  and  disappeared  two  or  three  times, 
from  which  we  should  argue  the  formation  of  adhesions. 
At  the  time  of  the  operation  it  was  described  as  a  large 
tumor  in  the  right  side  of  the  abdomen.  Smith  states 
that  the  patient's  health  was  not  greatly  impaired,  but 


3o6  MEDICINE    IN    AMERICA. 

that  "  she  was  sensibly  affected  by  the  disease"  and  read- 
ily consented  to  the  removal  of  the  tumor. 

His  description  of  the  operation  suggests  far  more  the 
technique  of  to-day  than  do  many  that  have  appeared 
during  the  intervening  years : 

"  An  assistant  rolled  up  the  tumor  to  the  middle  of 
the  abdomen  and  held  it  there.  I  then  commenced  an 
incision  and  extended  it  down  three  inches.  I  carried  it 
down  to  the  peritoneum  and  then  stopped  till  the  blood 
ceased  to  flow,  which  it  soon  did.  I  then  divided  the 
peritoneum.  The  tumor  now  exposed  to  view  was  punc- 
tured, a  cannula  introduced,  and  seven  pints  of  fluid  dis- 
charged. Previous  to  tapping  the  tumor,  by  inserting 
my  finger  by  the  side  of  it,  I  ascertained  that  it  adhered 
to  some  extent  to  the  parietes.  After  evacuating  the  fluid 
I  drew  out  the  sac,  which  brought  out  with  it,  and  ad- 
hering to  it,  a  considerable  portion  of  the  omentum.  This 
was  separated  from  the  sac  with  the  knife,  and  two 
arteries,  which  we  feared  might  bleed,  were  tied  with 
leather  ligatures  and  the  omentum  returned.  By  con- 
tinuing to  pull  out  the  sac  the  ovarian  ligament  was 
brought  out;  this  was  cut  off,  two  small  arteries  secured 
with  leather  ligatures,  and  the  ligament  was  then  re- 
turned. .  .  .  The  incision  was  closed  with  adhesive  plas- 
ter and  a  bandage  was  applied.  No  unfavorable  symp- 
toms occurred  after  the  operation ;  in  three  weeks  the 
patient  was  able  to  sit  up  and  walk,  and  has  since  per- 
fectly recovered.  .  .  . 

"  The  mode  of  operating,  practised  in  the  above  case, 
is  the  same  that  I  have  described  to  my  pupils  in  several 
of  my  last  courses  of  lectures  on  surgery.  The  event  has 
justified  my  previous  opinions." 

Certainly  the  man  who  could  do  and  write  that  eighty- 
five  years  ago  was  a  very  vital  person. 

At  the  present  day  it  is  not  easy  for  us  to  estimate  the 
extent  of  Smith's  influence  throughout   New   England, 


XIX.  CENTURY.     EARLY    PHYSICIANS.     307 

and  especially  in  New  Hampshire;  but  it  was  certainly 
very  great.  Francis  Bacon,  writing  in  1887  of  the  pro- 
fession in  New  Haven,  says  of  him  that  there  can  be  no 
hesitation  in  reckoning  Smith  the  most  eminent  medical 
man  whom  the  medical  profession  in  New  Haven  has 
ever  counted  among  its  members.  There  is  no  doubt  of 
that,  and  we  might  safely  add  to  New  Haven,  Maine, 
New  Hampshire,  and  Vermont.  But  it  was  in  New 
Hampshire  especially,  that  his  influence  was  felt.  Con- 
necticut and  Massachusetts  have  drawn  their  inspiration 
mostly  from  the  New  York  and  Harvard  teachers,  but 
in  Northern  New  England  Smith  has  had  few  rivals. 
However,  some  very  able  men  have  been  developed  among 
his  successors,  of  whom  Dixi  Crosby,  the  first  of  a  note- 
worthy family  of  New  Hampshire  physicians,  deserves 
to  be  remembered;  so,  too,  does  Jonathan  Knight,  of 
New  Haven,  for  many  years  Professor  of  Anatomy  and 
Physiology  there,  and  the  ablest  and  most  successful  sur- 
geon in  Connecticut  for  more  than  thirty  years,  until 
his  death  during  the  Civil  War  da3^s. 

But  it  would  be  going  too  far  afield  to  mention  by 
name,  even,  all  the  able  and  successful  men  who  flour- 
ished in  those  parts  of  New  England  during  many  of  the 
years  of  the  last  century.  In  some  fashion  their  works 
do  follow  them,  and  they  themselves  were  always  ready 
to  testify  to  the  inspiration  gathered  from  their  ancient 
preceptor  and  sometime  comrade,  Nathan  Smith. 

The  two  most  conspicuous  names  in  Boston  medicine 
of  the  last  century  are  those  of  Jackson  and  Bigelow.*' 
The  Jacksons,  father  and  son, — the  son  cut  off  in  his 
early  youth  and  the  subject  of  a  memorial  by  his  dis- 
tinguished father, — fill  a  unique  place  in  our  annals. 

The  Bigelows — father  and  son — both  lived  long  and 

°  The  following  sketch  was  originally  published  by  the  author  in 
the  Johns  Hopkins  Hospital  Bulletin,  January,  1902,  and  is  here 
reproduced  through  the  courtesy  of  the  editor  of  the  Bulletin. 


3o8  MEDICINE    IN    AMERICA. 

active  professional  lives,  their  working  years  covering 
in  all  more  than  eight  decades.  To  the  younger  genera- 
tion the  distinguished  son,  surgeon  and  teacher,  Henry 
J.  Bigelow,  is  the  better  known ;  but  I  doubt  whether  in 
future  annals  his  fame  will  eclipse  that  of  his  father. 

What  is  it  that  that  father  did?  On  what  does  his 
fame  rest?  Why  do  our  seniors  still  name  him  with  re- 
spect and  almost  with  reverence?  Men  who  knew  him 
tell  this  of  him.  He  was  a  wonderful  old  man;  his 
mind  was  alert  to  the  very  end;  he  was  full  of  wit,  hu- 
mor, and  satire;  he  was  wise,  acute,  profound;  and  he 
was  one  of  the  ablest  practitioners  we  ever  had.  But 
there  was  more  than  this  in  it  all.  What  the  man  did 
impressed  enormously  the  community  in  which  he  lived, 
the  source  of  the  impression  being  often  almost  un- 
realized. 

Jacob  Bigelow  was  born  on  February  27,  1787,  and 
died  on  Januarv^  10,  1879,  nearly  ninety-two  years  old. 
His  life  embraced  all  the  greatest  events  of  our  country's 
history,  from  the  adoption  of  the  Federal  Constitution, 
through  the  Reconstruction  days.  And  no  man  more 
than  he  grasped  the  meaning  of  all  that  wonderful  era. 
Born  at  a  time  of  political  expansion,  he  came  to  know 
personally  all  the  foremost  figures  of  the  age  among  us. 
John  Adams  complimented  him,  Thomas  Jefferson  cor- 
responded with  him,  Daniel  Webster  was  a  fellow-towns- 
man, Lincoln  and  Grant  were  familiar  to  his  riper  years : 
and  though  with  politics  he  never  had  active  concern,  he 
was  always  an  appreciative  student  of  national  develop- 
ment, and  in  his  place  was  an  aggressive  and  liberal  pro- 
moter of  reforms, — municipal,  social,  educational,  and 
scientific. 

He  was  of  New  England  ancestry.  His  great-great- 
great-gran  dfatlier  came  from  England  about  1640  and 
settled  in   Watertown,   Massachusetts.     In   that  vicinity 


XIX.  CENTURY.     EARLY    PHYSICIANS.     309 

the  family  always  lived.  His  father — Jacob  also — was 
a  Congregational  minister  in  Sudbury. 

The  younger  Bigelow's  childhood  was  passed  in  the 
country  at  farm  work  and  with  scant  schooling.  Pain- 
fully, his  father  was  enabled  to  send  him  to  Harvard 
College,  where  he  was  graduated  in  1806.  During  those 
early  years  he  was  not  slow  in  the  pursuit  of  useful 
knowledge.  Nature  always  charmed  him,  and  in  the 
study  of  her  mysteries  he  was  an  eager  scholar.  Flowers, 
the  succession  of  crops,  the  building  of  the  trees,  the 
changes  of  the  seasons,  meant  always  more  to  him  than 
to  the  average  simple  country  lad. 

In  college  he  was  not  unknown.  In  his  brief  autobio- 
graphical notes,  which  end  with  his  middle  life,  he  tells 
us  that  he  was  a  member  of  a  "  Theological  Society, 
which  was  very  good ;  a  Porcellian  Club,  which  was  very 
bad ;  a  Phi  Beta  Kappa  Society,  intended  to  be  composed 
of  the  best  scholars ;  and  a  Navy  Club,  which  was  above 
suspicion  as  containing  the  worst."  He  was  the  poet  of 
his  Commencement  day. 

Like  Astley  Cooper,  Bigelow  had  no  special  "  call." 
Beyond  the  fact  that  he  had  an  inborn  love  of  nature, 
there  was  nothing  to  lead  him  to  scientific  pursuits.  The 
choice  between  law,  theology,  and  medicine  exercised  him 
not  a  little,  and  he  tells  us  that  his  opinions  were  at  last 
confirmed  by  the  anatomical  lectures  of  John  Warren. 

Were  it  not  for  wandering  too  far,  it  would  be  interest- 
ing to  relate  Bigelow's  impressions  of  that  distinguished 
man,  for  he  used  often  to  speak  in  glowing  language  of 
the  great  fluency  and  charm  with  which  Warren  lectured. 

On  the  choice  of  a  profession,  Bigelow  had  many  inter- 
esting things  to  say,  and  in  his  later  years  contrasted  elo- 
quently the  great  range  of  pursuits  which  became  open 
to  aspiring  youth,  as  compared  with  the  narrow  things 
of  his  boyhood.  "  Few  young  men,"  he  says,  "  would 
then  have  cast  their  fortunes  on  the  uncertain  chance  of 


310  •  MEDICINE   IN   AMERICA. 

finding  occupation  and  livelihood  in  the  almost  unex- 
plored paths  since  successfully  pursued  by  multitudes  of 
educated  aspirants — in  the  capacities  of  engineers,  me- 
chanical and  chemical  manufacturers,  artists,  authors, 
editors,  lecturers,  and  teachers  of  the  higher  class.  Is 
it  not  possible  that  future  learned  professions  will  spring 
up  for  the  future  wants,  luxuries,  and  perversities  of 
mankind?  Why  should  not  cookery,  which  caters  to  the 
gratification  of  one  sense,  take  its  place  as  a  fine  art  by 
the  side  of  music  and  painting;  and  why  should  not  a 
refined  and  cultivated  anaesthesia  be  so  varied  in  its  appli- 
cations and  degrees  as  to  exempt  mankind  from  their 
griefs  and  grievances  by  an  artistic  application?" 

The  Harvard  School  and  a  residence  in  Boston  were 
beyond  the  reach  of  young  Bigelow  on  his  leaving  col- 
lege, so  he  spent  one  year  in  Worcester  as  tutor  and 
student  before  matriculating  in  the  Medical  School  of 
his  ab)ia  mater. 

In  1808  Bigelow  came  to  Boston  to  attend  the  lectures 
of  the  medical  professors,  entered  as  a  pupil  the  office  of 
John  Gorham,  and  eked  out  his  scanty  income  by  teach- 
ing in  the  Boston  Latin  School.  He  became  a  student  of 
science  while  continuing  to  broaden  his  familiarity  with 
the  classics. 

He  passed  but  one  year  in  Boston ;  then  went  to  Phila- 
delphia, in  1809,  for  the  lectures  of  Rush,  Wistar, 
Physick,  Barton,  and  Coxe,  and  to  obtain  the  doctor's 
degree.     He  was  then  twenty-three  years  old. 

From  the  very  outset,  Bigelow  showed  characteristics 
familiar  enough  in  American  youths, — ambition,  cour- 
age, confidence  in  himself,  adaptability  to  his  surround- 
ings, versatility,  a  keen  sense  of  perspective,  humor  in  its 
])est  sense,  and  an  inexhaustible  capacity  for  work.  When, 
during  his  medical  course,  funds  from  home  failed  him, 
he  took  to  teaching.  To  bring  himself  early  before  the 
professional  public,  he  took  to  writing,  and  secured  the 


XIX.  CENTURY.     EARLY    PHYSICIANS.     311 

handsome  Boylston  Prizes  in  four  successive  years;  in- 
deed, it  began  to  be  said  that  the  Boylston  Prize  was 
instituted  for  Bigelow's  benefit.  Coming  to  Boston  penni- 
less, unknown,  without  friends  or  connections,  he  culti- 
vated from  the  outset  the  best  among  his  contemporaries 
and  was  an  early  member  of  their  social,  professional,  and 
literary  gatherings.  Among  those  men,  friends  of  his 
youth,  were  Alexander  Everett,  a  brother  of  Edward, 
George  Ticknor,  H.  D.  Sedgwick,  Nathan  Hale,  Edward 
T.  Channing,  and  William  P.  Mason. 

So  well  known  had  he  become  and  so  promising  seemed 
his  career  that  within  two  years  the  elder  James  Jackson 
chose  him  as  his  associate  in  practice.  Jackson  had  re- 
cently been  appointed  Professor  of  Theory  and  Practice 
at  Harvard. 

Early  there  became  evident  in  Bigelow  a  facility  in 
the  handicrafts  which  was  equalled  only  by  his  brillianc}'' 
in  intellectual  pursuits.  That  he  gave  himself  largely  to 
the  subjects  of  therapeutics  and  internal  medicine  has 
always  been  an  interesting  fact.  He  would  doubtless 
have  succeeded  as  a  surgeon,  as  did  his  distinguished  son. 
He  was  a  born  artist,  artificer,  craftsman,  mechanician, 
and  inventor,  and  there  has  probably  never  been  a  man 
better  equipped  by  natural  endowment  for  success  in  all 
branches  of  the  healing  art.  So  far  as  appears,  he  never 
had  any  regular  instruction  in  mechanics,  but  qualified 
for  these  pursuits  by  persistent  personal  inquiry  and  the 
exercise  of  his  natural  genius. 

When  occasion  came  for  illustrating  his  "  American 
Medical  Botany"  with  colored  engravings,  and  before 
modern  methods  of  lithographing  were  invented,  he  him- 
self devised  a  means  of  illustration  which  proved  both 
practical  and  beautiful.  When  he  wished  for  drawings 
and  models  for  his  lectures  as  Rumford  professor,  he 
knew  how  to  make  them.  When  he  was  called  upon  to 
lay  out  the  plan  of  Mount  Auburn  Cemetery,  he  proved 


312  MEDICINE    IN   AMERICA. 

himself  an  ingenious  and  practical  landscape  gardener. 
He  was  wont  to  appear  in  every  workshop,  garret,  and 
cellar  in  Boston  where  artisans  or  mechanics  would  grant 
him  entrance  and  answer  his  cjuestions.  He  knew  what 
was  done  and  how  done  by  smith,  glass-blower,  clock- 
maker,  type-caster,  printer,  moulder,  and  engraver. 

At  the  age  of  twenty-five,  when  less  than  two  years 
in  practice,  his  extra-professional  activities  were  punc- 
tuated by  an  election  to  the  Anthology  Club,  a  famous 
literary  body  which  was  founded  in  1805  with  fourteen 
members,  and,  after  a  flourishing  existence  of  many  years, 
developed  into  that  most  unique  and  popular  of  all  pri- 
vate libraries,  the  Boston  Athenaeum. 

Of  course  he  joined  the  Massachusetts  Medical  Society, 
and  was  early  honored  with  an  election  to  the  Massa- 
chusetts Historical  Society  and  the  American  Academy 
of  Arts  and  Sciences. 

In  1 81 2,  too,  his  interest  in  the  study  of  botany  and  his 
appreciation  of  its  possibilities  led  him  to  give  a  course 
of  popular  lectures  on  botany  in  Boston,  under  the  patron- 
age of  John  Lowell. 

Bigelow  often  said  what  has  been  said  by  many  other 
distinguished  and  successful  men,  that  a  professional  man 
should  have  a  hobby.  I  suppose  his  own  hobby  was  bot- 
any ;  though,  indeed,  he  rode  many  little  hobbies  besides. 
At  any  rate,  to  botany  he  first  betook  himself  in  no  ama- 
teurish fashion,  and  studied  and  lectured  and  wrote  books. 
"  Florula  Bostoniensis"  was  one  of  them, — a  volume  well 
known  to  our  grandfathers;  a  charming,  comprehensible 
English  book,  bringing  nature  and  fields  and  forests  and 
flowers  nearer  to  simple  minds. 

Now,  these  studies  of  young  Bigelow  brought  him 
many  friends  near  liome  and  distinguished  correspond- 
ents from  abroad.  Such  were  Henry  Muhlenburg,  of 
Pennsylvania;  the  Abbe  Correa  de  Serra,  at  that  time 
Portuguese  minister  at  Washington,   perhaps  the  best- 


XIX.  CENTURY.    EARLY    PHYSICIANS.     313 

cultivated  man  in  America, — kindly,  learned,  much  ac- 
quainted, widely  known  in  science;  and  there  were  also 
such  correspondents  as  Sir  J.  E.  Smith,  Desfontaines,  Jus- 
sieu,  and  de  Candolle. 

So  Bigelow  began  to  be  known  among  the  wise  men  of 
Europe,  before  he  was  thirty,  and,  being  no  pedant,  was 
liked  among  common  folk  at  home.  His  practice  among 
them  spread,  and  Harvard  College  appreciated  him  and 
made  him  a  professor. 

In  181 5  he  was  appointed  lecturer  on  Materia  Medica 
and  Botany;  and  in  181 7,  when  he  was  thirty,  they 
changed  his  title  to  professor,  and  made  him  the  colleague 
of  James  Jackson,  J.  C.  Warren,  John  Gorham,  and 
Walter  Channing.     He  held  the  chair  for  forty  years. 

Many  writers  have  observed  that  a  man's  most  inter- 
esting years  are  his  early,  formative  ones,  and  novelists 
have  made  use  of  this  fact.  But  it  was  not  altogether 
so  with  Jacob  Bigelow.  While  poor  and  young,  strenu- 
ous and  ingenuous,  he  was  an  interesting  figure;  but  I 
hope  to  show  that  he  remained  an  interesting  figure,  rich 
and  old,  still  strenuous  and  wise. 

There  is  little  time  or  space  to  tell  much  of  those  early 
years.  He  was  a  poet,  for  he  read  a  Phi  Beta  Kappa 
poem  at  Commencement  on  the  theme  "  Professional 
Life,"  in  words  somewhat  original,  in  style  Drydenesque. 
And  while  he  was  doing  these  intellectual  things,  his 
hands  were  not  idle  nor  his  tongue  backward  in  telling 
of  his  tasks.  Of  his  many-sidedness  perhaps  I  have  said 
enough,  and  it  will  illustrate  the  "  why"  of  his  being 
appointed  Rumford  professor  and  lecturer  on  the  Appli- 
cation of  Science  to  the  Useful  Arts  at  Harvard. 

He  was  the  first  Rumford  professor,  and  again,  were 
it  not  for  the  limited  space,  it  would  be  pleasant  to  say 
something  of  that  distinguished  Count  Rumford,  and  to 
tell  Tyndall's  delightful  story  of  his  romantic  and  useful 
life.     But  Rumford  was  dead,  and  had  left  some  monev 


314  MEDICINE   IN   AMERICA. 

to  Harvard  College  for  the  purpose  aforesaid,  and 
Bigelow  was  appointed  to  carry  out  the  purpose, — a  man, 
I  believe,  after  Rumford's  own  heart. 

This  novel  bequest  of  Rumford,  which  established  a 
professorship  with  an  annual  income  of  one  thousand  dol- 
lars, marks  an  interesting  departure  in  American  univer- 
sity education.  It  seems  to  have  been  accepted  by  the 
College  with  a  certain  amount  of  scepticism  at  first;  but 
the  unusual  talents  and  ability  of  the  first  professor  shed 
a  light  upon  utilitarian  topics  which  was  entirely  unsus- 
pected by  the  dons  of  that  day. 

On  December  ii,  1816,  Bigelow  devoted  his  opening 
lecture  to  the  Life  and  Works  of  Count  Rumford.  The 
address  was  printed,  and  its  force,  sanity,  and  eloquence 
met  with  praise  from  men  of  all  sorts. 

Probably  this  appointment,  and  the  meaning  of  it  all, 
was  for  Bigelow  the  most  significant  event  of  his  life. 
Doubtless,  the  developing  science  of  the  last  century 
would  have  had  in  him  an  enthusiastic  student  under  any 
circumstances;  but  it  is  fair  to  suppose  and  pleasant  to 
believe  that  Rumford,  the  distinguished  American,  the 
idol  of  foreign  courts,  the  founder  of  scientific  bodies, 
stimulated  and  left  behind  him  in  his  native  State  a 
young  disciple  who  needed  only  that  brilliant  and  success- 
ful example  to  lead  him  wisely  towards  the  pursuit  of 
truth. 

Of  those  first  lectures  of  Bigelow,  the  youthful  pro- 
fessor, one  can  give  but  slight  account.  The  showing  of 
apparatus  and  the  description  of  technics  lend  themselves 
feebly  to  the  printed  page.  But  we  know  that  the  lectures 
were  successful  and  stimulated  a  growing-  demand  for 
the  popular  demonstration  of  the  elements  of  science.  To 
Bigelow  himself  their  value  was  doubtless  greatest,  as  has 
been  said.  He  was  the  first  of  a  line  of  distingui.shed 
men  to  hold  the  chair,  and  is  represented  in  it  to-day 
by  Wolcott  Gibbs,  professor  emeritus,  and  John  Trow- 
bridge, the  actual  incumbent. 


XIX.  CENTURY.     EARLY    PHYSICIANS.     315 

Then  there  was  that  other  pursuit, — botany, — which, 
with  medicine  and  technology,  occupied  his  hfe.  The 
httle  book  on  Boston  flora,  pubhshed  in  1814,  was  popular 
at  once.  The  subject  was  so  plainly  and  charmingly 
handled  that  the  volume  had  a  large  circulation  among 
the  laity  from  its  first  publication.  Ten  years  later,  in 
1824,  a  second  and  very  much  enlarged  edition  appeared. 

This  was  only  the  beginning  of  his  botanical  givings 
forth.  The  work  for  which  he  was  early  distinguished, 
which  brought  him  into  closest  contact  with  the  savants 
of  Europe  and  gave  him  honor  in  his  own  country,  was 
the  elaborate  series  of  volumes  published  under  the  title 
"  American  Medical  Botany."  This  treatise  purports  to 
cover  the  ground  indicated  by  its  title  in  a  popular  as  w^ell 
as  exhaustive  manner,  and  a  special  feature  in  it  is  the 
elaborate  system  of  plates  designed  and  largely  executed 
by  Bigelow  himself. 

These  rare  volumes  impress  one  strongly  with  the  style 
and  method  of  their  contents;  the  distinctness,  finish,  and 
beauty  of  their  illustrations;  and  the  excellence  of  their 
appearance  as  regards  paper  and  typography,  which 
would  make  them  creditable  productions  at  the  present 
day.  Their  popularity  with  the  unprofessional  reader  was 
enhanced  by  the  author's  avoidance  of  technical  terms. 

Bigelow's  eminence  as  a  botanist  was  recognized  also 
by  his  being  appointed  an  editor  of  the  first  edition  of 
the  "  United  States  Pharmacopoeia,"  in  1820,  at  the  age 
of  thirty-three,  in  association  with  Spaulding,  of  New 
York;  Hewson,  of  Philadelphia;  Ives,  of  New  Haven; 
and  De  Butts,  of  Baltimore.  In  this  publication  Bigelow's 
scheme  of  simplifying  nomenclature  was  followed,  thus 
distinguishing  the  American  Pharmacopoeia  from  that 
of  Great  Britain. 

In  18 1 7,  when  thirty  years  old,  Bigelow  married  Mary 
Scollay,  of  Boston.  They  had  five  children,  one  of  whom 
was  Henry  Jacob,  famous  among  American  surgeons. 


3i6  MEDICINE    IN   AMERICA. 

So  in  the  year  1820  we  may  regard  Jacob  Bigelow  as 
well  launched  in  his  calling.  Though  still  young,  a  recog- 
nized authority  on  botany,  a  distinguished  lecturer  on 
applied  science,  a  successful  teacher  and  practitioner  of 
medicine,  and  already  approaching  the  acme  of  his  life 
work  as  a  physician,  let  us  believe,  though  the  exact 
extent  of  his  activities  is  not  entirely  apparent. 

To  one  studying  the  profesional  conditions  in  Boston 
at  that  day  the  burden  of  incessant  practice  would  appear 
to  have  been  less  onerous  than  it  has  since  become.  Bos- 
ton was  fortunate  in  a  goodly  number  of  eminent  doctors, 
and  though  fees  were  small,  as  we  reckon  fees,  it  would 
appear  that  all  were  comfortably  supported  in  that  frugal 
generation.  Indeed,  as  regards  many  of  those  well- 
known  men,  one  is  not  impressed  with  the  sense  of  their 
incessant  and  overburdened  professional  activities,  great 
incomes,  and  increasing  demand  for  their  services,  as  was 
the  case  with  their  English  contemporaries.  They  seem 
to  have  had  time  for  a  diversity  of  interests,  and  it  is 
for  this  reason,  perhaps,  that  they  have  left  behind  them 
the  reputation  for  wide  philanthropy,  good  literary  and 
scientific  attainments,  and  respectable  scholarship. 

In  the  present  day  all  Boston  physicians  are  not  con- 
spicuously public-spirited ;  tradition  says  that  in  this  they 
have  degenerated.  However  that  may  he,  and  whatever 
the  cause,  in  Jacob  Bigelow  we  have  a  conspicuous  ex- 
ample of  the  reverse.  Through  life  he  was  eager  and 
forward  in  many  public  movements ;  in  some  of  them  an 
originator  and  leader.  As  with  most  men,  the  story  of  his 
life  gravitates  naturally  into  three  chapters, — develop- 
ment, maturity,  and  age.  In  all  except  the  last  he  was 
precocious,  and  for  this  reason  his  activities  covered  a 
multitude  of  years.  We  have  traced  him  through  the  first 
cha])ter.  Let  the  second  chapter  begin  at  the  age  of 
thirty-eight,  and  be  u.shered  in  with  the  inception  of  his 


XIX.  CENTURY.     EARLY    PHYSICIANS.     317 

first  conspicuous  public  service,  the  founding  of  Mount 
Auburn  Cemetery. 

Up  to  this  time  (  1825)  the  dead  of  our  cities  had  been 
buried  in  the  city  church-yards  and  vauhs,  and  the  prob- 
lem of  their  disposal  was  becoming  an  urgent  and  a  dis- 
tressing one.  With  the  increase  of  population  the  ground 
was  being  encroached  upon  at  the  same  time  that  burials 
were  becoming  more  frequent.  Many  of  the  older  church- 
yards had  long  been  full.  Interments  were  made  in  graves 
already  occupied,  and  ancient  bones  were  being  disin- 
terred and  removed.  Shocking  as  all  this  was  to  the  sen- 
sibility of  the  community,  the  danger  to  the  public  health 
was  becoming  more  serious.  All  this  had  long  been  a 
matter  of  grave  concern  to  Bigelow,  and  in  this  year  he 
called  together  at  his  house  a  small  company  of  prominent 
men  to  discuss  the  situation  and  its  remedy.  He  proposed 
to  them  a  plan  which  met  with  their  cordial  approval, 
though  when  it  was  made  public  it  was  received  with  a 
storm  of  opposition  and  ridicule. 

Bigelow's  proposition  was  the  founding  of  an  extra- 
urban  forest  cemetery.  In  a  delightful  and  convincing- 
series  of  papers  he  pointed  out  the  reasonableness  of  this 
plan  and  the  offence  of  the  existing  methods.  The  argu- 
ments he  used  are  familiar  enough  to-day.  Little  was 
needed  to  show  the  disadvantage  of  past  conditions  and 
the  advantage  of  returning  bodies  to  a  virgin  soil  where 
rapid  decomposition  in  a  forest  garden  might  go  on  un- 
checked.    This  was  told  graphically  and  strikingly. 

For  seven  years  the  debate  went  on,  until,  in  1832,  in 
spite  of  constant  and  powerful  dissent,  the  cemetery  at 
Mount  Auburn  was  dedicated  for  public  use.  The  place 
is  situated  in  a  piece  of  woods  about  a  mile  from  Harvard 
College,  on  the  banks  of  the  Charles,  and  had  long  been 
a  favorite  resort  for  lovers  of  nature.  The  students  had 
named  it  "  Sweet  Auburn." 

In  every  sense  Bigelow  was  the  founder  and  promoter 


3i8  MEDICINE    IN   AMERICA. 

of  this  modern  cemetery.  He  laid  out  the  grounds;  he 
thinned  the  trees;  he  surveyed  the  roads,  paths,  and 
hedges ;  he  supervised  its  ornamentation ;  he  designed  its 
classic  gateway  and  approach.  For  it,  indeed,  he  became 
the  first  of  our  landscape  architects. 

The  success  of  the  new  plan  was  instantaneous  and  pro- 
nounced. From  the  very  opening  of  the  cemetery  it  ap- 
pealed to  the  sentiments  as  well  as  to  the  reason  of  our 
people,  and  numberless  imitations  were  promptly  pro- 
jected in  all  parts  of  the  country.  As  long  as  he  lived, 
Bigelow  continued  an  active  supporter  and  director  of  this 
work. 

In  1872.  forty  years  later,  he  planned  and  presented  to 
the  trustees  the  famous  Mount  Auburn  Sphinx, — a  me- 
morial to  the  Union  soldiers  of  our  Civil  War.  It  bears 
this  inscription : 

"  America  conservata 

Africa  liberata 

Populo  magno  assurgente 

Heroum  sanguine  fuso." 

The  year  1832  was  marked  by  the  outbreak  of  a  great 
cholera  epidemic  in  this  country,  and  the  disease  raged 
fearfully  in  many  of  the  seaboard  towns.  In  New  York 
three  thousand  died,  and  the  city  was  almost  deserted  by 
the  terrified  inhabitants.  Those  must  have  been  very 
stirring  days,  if  we  can  believe  even  the  colorless  recital 
of  Bigelow's  biographer. 

Early  in  the  epidemic,  and  before  it  reached  Boston, 
the  authorities  there  determined  on' vigorous  measures 
for  the  protection  of  that  city.  A  strict  quarantine  was 
enforced,  and  a  number  of  eminent  physicians  were  in- 
vited to  investigate  the  New  York  conditions.  It  is 
stated  that  some  of  those  who  were  asked  to  take  part 
in  this  work  found  reasons  for  declining;  but  Bigelow, 
Ware,  and  Flint  willingly  offered  their  services  and  went 
as  commissioners  to  the  stricken  city. 


XIX.  CENTURY.     EARLY    PHYSICIANS.     319 

The  conditions  they  found  there  were  said  to  beggar 
description  :  terror  everywhere ;  deserted  streets,  crowded 
hospitals,  frightened  attendants,  and  devoted  physicians. 
It  was,  indeed,  such  a  plague  as  was  known  to  the  Italy 
of  the  Middle  Ages.  The  Boston  physicians  saw  and  re- 
ported. They  visited  the  hospitals,  they  conferred  with 
the  authorities,  they  studied  the  cases,  and  they  found  a 
state  of  affairs  far  worse  than  rumor  had  pictured. 

Their  mission  ended,  they  returned  home,  through 
some  difficulties,  we  are  told,  for  local  authorities  refused 
them  passport.  They  were  actually  turned  away  from 
the  city  of  Providence  and  forced  by  a  circuitous  route 
to  make  their  journey  to  Boston.  So  grievous  is  their 
report  said  to  have  been  that  the  mayor  of  Boston  with- 
held it  from  publication  for  fear  of  alarming  the  com- 
munity; but  their  recommendations  were  of  the  greatest 
value,  and  through  their  efforts  the  disease  was  largely 
averted  from  the  town;  the  mortality  figures  showing 
that,  while  New  York  lost  three  thousand  by  death  and 
many  other  seaboard  cities  between  one  and  two  thousand, 
the  deaths  in  Boston  numbered  one  hundred  in  all. 

It  seems  as  though,  with  the  approach  of  middle  age, 
Bigelow  had  already  accomplished  a  good  life  work. 
Indeed,  he  himself  seems  so  to  have  thought.  In  1833 
he  was  forty-six  years  old,  and  felt  himself  to  have  earned 
a  rest  from  his  constant  labors.  In  this  year,  then,  he 
went  to  Europe  for  the  first  time, — a  mature  man,  famous 
in  his  own  country  and  already  well  known  to  foreign 
scholars.  One  of  his  companions  on  this  voyage  was 
young  Oliver  Wendell  Holmes,  his  pupil,  a  recent  gradu- 
ate in  medicine,  going  to  Paris  to  complete  his  education. 

With  this  voyage  ends  the  story  told  in  Bigelow's  mod- 
est autobiography. 

Beginning  with  this  second  era, — his  middle  age, — 
his  activities  continued  in  many  new  directions.  He  was 
Visiting  Physician  to  the  Massachusetts  General  Hospital, 


320  MEDICINE    IX    AMERICA. 

Professor  of  Materia  Medica  at  Harvard,  conducted  an 
enormous  consulting  practice,  was  a  ver}'  frequent  con- 
tributor to  the  press  on  matters  of  public  interest,  and 
was  chairman  or  trustee  of  many  important  pubhc  and 
private  organizations.  But.  above  all.  he  became  con- 
spicuous for  the  great  reforms  which  he  instituted  in  the 
practice  of  medicine. 

}iIount  Auburn  will  always  remain  a  monument  to 
Bigelow,  the  citizen.  But  the  physician's  work  as  a 
pioneer  in  science  should,  and  I  believe  will,  give  him  a 
more  permanent  place  in  our  annals. 

At  the  outset  of  his  professional  life  he  was  imbued 
with  the  prejudices  and  traditions  of  the  so-called  heroic 
method.  He  had  been  taught  that  the  department  of 
therapeutics  was  the  most  important  in  medical  practice. 
This  was  the  belief  of  all  the  world  at  that  time,  and, 
with  few  exceptions,  physicians  regarded  the  study  of  dis- 
ease, the  careful  review  of  etiolog}'.  the  course  and  nature 
of  symptoms,  the  appearance  of  morbid  processes,  and  the 
proper  estimate  of  prognosis  as  very  secondan,'  matters. 

To  be  sure,  there  were  in  France  and  England  a  few 
men  who  were  beginning  to  appreciate  the  value  of  ob- 
servation, and  about  this  time  the  statistical  method  rather 
than  the  study  of  individual  cases  had  its  inception ;  but 
such  work,  and  especially  that  of  Louis  in  Paris,  was 
as  yet  little  known.  In  our  own  country,  medicine  had 
advanced  but  little  beyond  the  teaching  of  the  eighteenth 
century,  and,  with  the  exception  of  Jenner's  vaccine,  we 
were  still  in  darkness. 

Very  early  in  his  career,  and  influenced  by  his  interest 
in  and  pursuit  of  science  in  broader  fields,  Bigelow  was 
led  to  a  habit  of  observation  and  just  conclusion.  He 
came  to  see  that  disease  is  by  no  means  susceptible  of 
ready  curtailment ;  that  great  numbers  of  processes  run 
a  definite  course,  with  spontaneous  recovery;  that  other 
processes  subside  and  recur  periodically ;   that  others  still 


XIX.  CENTURY.     EARLY    PHYSICIANS.     321 

persist  to  the  end  uninfluenced  by  therapeutic  measures; 
and  that  there  is  underlying  it  all  a  vis  medicatrix  natures 
too  little  reckoned  with. 

In  those  early  days,  too,  when  ingenious  men  were  ad- 
vancing theories  founded  on  speculation  and  insufficient 
observation,  and  when  text-books  were  loaded  with  ex 
cathedra  dicta,  dogmatic  teachers  were  looked  up  to  by 
the  public  and  by  medical  students  as  almost  divine 
healers.  The  teaching-  of  Hahnemann  and  the  wide  en- 
thusiasm of  his  followers  in  homoeopathy  had  led  great 
numbers  of  persons  to  regard  the  ancient  methods  as  hum- 
bug, and  many  educated  men  were  being  led  away  into 
these  new  practices. 

Bigelow  saw  clearly  and  pointed  out  the  significance 
and  meaning  of  it  all.  His  voice  was  heard  in  the  land, 
and  for  many  years,  in  season  and  out  of  season,  he 
ceased  not  his  demonstrations  of  the  self-limited  character 
of  disease.  All  of  this  is  now  so  trite  and  so  familiar, 
even  to  the  intelligent  among  the  laity,  that  it  seems  a 
little  thing;  but  the  daring  of  it  and  the  success  of  the 
pioneer  in  those  days  were  very  heroic  and  real. 

In  1835,  in  an  address  on  "  Self-limited  Diseases"  be- 
fore the  Massachusetts  Medical  Society,  Bigelow  struck 
the  true  note,  and  the  effect  was  instantaneous  and  im- 
mense. In  popular  opinion,  homoeopathy  has  the  credit 
of  inciting  and  furthering  that  radical  change  in  the 
methods  of  medical  practice  which  has  prevailed  among 
us  for  two  generations.  Quite  otherwise  is  the  truth. 
Writing  in  1880,  Oliver  Wendell  Holmes  sa3^s,  in  refer- 
ence to  this  address  of  Bigelow,  "  This  remarkable  essay 
has  probably  had  more  influence  on  medical  practice  in 
America  than  any  similar  brief  treatise,  we  might  say 
than  any  work  ever  published  in  this  country.  Its  sug- 
gestions were  scattered  abroad  at  the  exact  fertilizing 
moment  when  public  opinion  was  matured  enough  for 
their  reception." 

21 


322 


MEDICINE    IN   AMERICA. 


In  1852  Bigelow  delivered  before  the  students  of  the 
Massachusetts  Medical  College  in  Boston  a  striking  ad- 
dress on  medical  education,  the  key-note  of  which  was 
similar  to  that  of  his  famous  essay  on  "  Self-limited  Dis- 
eases;" at  the  same  time  he  urged  upon  his  students  the 
great  importance  of  a  thorough  scientific  training.  This 
was  twenty  years  before  that  beginning  of  reform  in 
medical  education  in  America  which  was  initiated  by 
Harvard  some  thirty  years  ago.  The  trend  of  Bigelow's 
remarks  was  in  the  line  of  those  better  things  with  which 
we  are  now  familiar. 

He  naturally  deprecated  the  vicious  practice  of  that  day 
which  allowed  students  to  qualify  for  the  degree  after 
two  short  courses  of  lectures  and  a  certain  amount  of 
practice  in  the  offices  of  physicians.  But  he  went  further 
than  merely  urging  that  three  and  four  years'  course  of 
medical  study  with  which  our  generation  is  familiar;  he 
anticipated  and  advocated  that  development  of  special 
instruction  to  which  to-day  we  are  turning. 

He  recognized  the  usefulness  and  importance  of  didac- 
tic lectures ;  but  original  research  on  the  part  of  students, 
and  personal  investigations  in  laboratories,  in  small 
classes,  under  the  supervision  of  competent  instructors, 
he  advocated  as  most  important  of  all.  His  views  on 
this  subject  coincide  with  those  of  the  leading  scientists 
of  modern  times,  and  it  is  interesting  to  recall  that  Hux- 
ley, forty  years  ago,  insisted  upon  the  personal  as  distin- 
guished from  the  second-hand  methods  of  study. 

Bigelow  then  went  on  in  his  characteristic  style  to  de- 
fine the  exact  sciences  and  the  speculative  sciences;  pre- 
eminent among  the  latter  he  placed  practical  medicine, — 
"  a  science  older  than  civilization,  cultivated  and  honored 
in  all  ages,  powerful  for  good  or  for  evil,  progressive  in 
its  character  but  still  unsettled  in  its  principles,  remunera- 
tive in  fame  and  fortune  to  its  successful  cultivators,  and 
rich  in  the  fruits  of  a  good  conscience  to  its  honest  vo- 


XIX.  CENTURY.     EARLY    PHYSICIANS,      t^zt, 

taries.  Encumbered  as  it  is  with  difficulty,  fallacy,  and 
doubt,  medicine  yet  constitutes  one  of  the  learned  pro- 
fessions. It  is  largely  represented  in  everv^  city,  village, 
and  hamlet.  Its  imperfections  are  lost  sight  of  in  the 
overwhelming  importance  of  its  objects.  The  living  look 
to  it  for  succor;   the  dying  call  on  it  for  rescue." 

He  proceeded  more  elaborately  to  explain  the  difficul- 
ties of  therapeutics,  using  the  old-time  comparison  be- 
tween the  physician  and  the  experienced  pilot,  and  show- 
ing that  the  rocks  and  narrows  in  the  pilot's  course  must 
be  known  to  him,  this  knowledge  being  of  far  more 
importance  for  the  safety  of  his  bark  than  his  abilit}'  to 
calm  the  winds  and  the  waves.  And  so  he  comes  to  the 
inevitable  conclusion — for  us  now  the  last  word — '"  that 
he  is  a  great  physician  who  above  other  men  understands 
diagnosis." 

This  charming  essay,  intended  for  young  beginners, — 
lucid,  free  from  technicalities, — can  be  read  by  any  lay- 
man, and  is  indeed  a  very  missionary  tract.  These  two 
essays  and  a  number  of  others  on  medical  and  general 
topics — homoeopathy,  quacker}',  burial  of  the  dead,  pneu- 
mothorax, tea  and  coffee,  the  history  and  use  of  tobacco, 
etc. — are  bound  together  in  a  little  volume,  entitled  "  Na- 
ture in  Disease,  and  Other  Writings,"  published  in  1854. 

In  the  last  generation  this  book  was  to  be  found  on  the 
shelves  of  everv^  well-equipped  library  in  New  England. 
Simple  and  unpretentious,  its  influence  inside  and  outside 
the  profession  was  immense,  and  I  believe  that  to  it  more 
than  to  the  writings  of  any  other  one  man  we  owe  the 
appreciation  and  popularity  of  the  medical  profession  in 
this  country. 

In  such  studies  and  pursuits,  then,  we  must  believe  that 
Bigelow  immersed  himself  for  the  many  years  of  his  long 
middle  age. 

Of  his  private  life  there  is  no  space  to  tell,  nor  of  his 
connection  with  the  stirring  events  preceding  and  accom- 


324  MEDICINE    IN    AMERICA. 

panying  the  Civil  War.  Side  glimpses  of  him  we  have 
in  the  records  of  medical  societies  of  those  days;  notice 
of  his  constant  attendance  at  such  meetings;  and  quota- 
tions from  his  strong,  wise,  and  earnest  sayings.  In  those 
years  his  son,  Henr}^  J.  Bigelow,  was  coming  rapidly  to 
the  front  as  teacher  and  practitioner  of  surgery';  and 
during  the  Civil  War  both  of  these  men,  father  and  son. 
were  already  past  the  military  age,  so  that  their  public 
labors  in  those  trying  times  were  little  associated  with 
the  activities  of  camp  and  battle.  The  high  patriotism 
of  the  elder  man  we  know,  for  is  it  not  evidenced  by  that 
monument  which  he  himself  designed? 

W^ith  the  war  began  the  third  era  in  Bigelow's  life, — 
his  old  age.  Still  useful,  still  forceful,  his  endeavor  was 
constant  for  the  intellectual  uplifting  of  his  fellows. 
Throughout  his  long  career,  his  utilitarian  studies,  his 
contact  with  eminent  scientific  men  of  all  countries,  and 
his  abundant  experience  as  a  practitioner  of  medicine  con- 
firmed him  in  the  belief  that  the  old-time  pursuit  of  the 
classics,  the  traditional  "  liberal  education,"  was  for  suc- 
cess and  usefulness  in  life  by  no  means  salient.  Indeed, 
he  had  convinced  himself  that  in  our  days  a  liberal  educa- 
tion should  mean  far  more  than  an  intimacy  with  the 
ancient  classics;  and  this,  too,  in  spite  of  his  own  high 
training  and  accomplishments  in  that  branch  of  learning. 

With  such  convictions.  Bigelow  took  a  profound  inter- 
est in  the  Massachusetts  Institute  of  Technology,  which 
was  incorporated  in  the  early  days  of  the  Civil  War ;  and 
at  the  dedication  of  its  new  hall,  on  November  i6,  1865. 
he  delivered  a  striking  address  on  the  "  Limits  of  Educa- 
tion." His  object  was  to  break,  or  rather  to  extend,  those 
limits  in  a  way  to  make  education  "  conduce  most  to  the 
progress,  the  efficiency,  the  virtue,  and  the  welfare  of 
men."  This  address  is  so  striking,  so  in  advance  of  the 
times,  so  complete,  even  for  us  to-day.  and  so  little  has 


XIX.  CENTURY.     EARLY    PHYSICIANS.     325 

been  added  to  it  by  more  recent  thinkers,  that  it  is  difficult 
to  pass  it  by  without  quotation. 

The  early  training  of  a  pupil  must  be  as  thorough  as 
possible;  "but  after  this  is  completed,  a  special  or  de- 
partmental course  of  studies  should  be  selected, — such 
as  appears  most  likely  to  conduct  him  to  his  appropriate 
sphere  of  usefulness.  Collateral  studies  of  different  kinds 
may  always  be  allowed;  but  they  should  be  subordinate 
and  subsidiary  and  need  not  interfere  with  the  great  ob- 
jects of  his  especial  education." 

"  A  common  college  education  now  culminates  in  the 
student's  becoming  what  is  called  a  master  of  arts;  but 
this,  in  the  majority  of  cases,  means  simply  a  master  of 
nothing." 

He  assigns  much  of  the  modern  conditions  among  us 
to  English  conservatism,  for  the  conservation  of  a  privi- 
leged order.  "  It  is  the  duty  of  educational  institutions 
to  adapt  themselves  to  the  wants  of  the  place  and  time  in 
which  they  exist." 

"Life  is  no  less  short  now  that  it  was  for  the  Roman 
poet,  but  art  is  vastly  longer." 

Such  earnest  thoughts  as  these  were  much  in  Bigelow's 
mind,  and  he  soon  carried  them  to  the  American  Academy 
of  Arts  and  Sciences,  over  which  he  had  long  presided. 

In  his  address  before  the  Academy  the  next  year  he 
developed  the  same  theme ;  realizing  the  immense  demand 
of  this  expanding  country  for  the  services  of  expert,  edu- 
cated men  "  in  its  cities  and  mining  regions  and  factories 
and  workshops ;  for  skilled  labor,  for  chemists,  engineers, 
architects,  constructors,  overseers." 

A  great  antagonism  was  aroused,  but  the  majority  of 
critics  were  friendly. 

Out  of  this  turmoil,  and  especially  out  of  a  challenge 
on  the  arena  of  the  Academy,  came  a  further  reply  from 
Bigelow.  His  biographer  describes  the  scene  from  mem- 
ory :  a  social  meeting  of  the  Academy  at  Bigelow's  house 


326  MEDICINE   IN   AMERICA. 

on  the  evening  of  November  20,  1866;  the  title,  "On 
Classical  and  Utilitarian  Studies." 

This  paper  was  the  longest,  the  most  elaborate,  and  the 
most  learned  of  his  written  productions.  Of  it  his  biog- 
rapher says,  "  The  sparkle  and  brilliancy  of  its  style,  the 
exuberance  of  its  playful  humor,  the  keenness  of  its  occa- 
sional satire,  the  compass  and  wealth  of  its  scholarship, 
the  cogency  of  its  accumulative  argument  and  demonstra- 
tive affirmation  may  claim  for  that  essay  a  very  high  dis- 
tinction among  the  masses  of  our  recent  like  produc- 
tions." 

The  pith  of  his  argument  is  this, — and  it  is  the  argu- 
ment underlying  the  whole  trend  of  modern  democratic 
thought :  that  education  is  the  right  of  the  many  and 
not  the  privilege  of  the  few ;  that  that  conservatism  which 
restricts  education  to  the  classics  and  what  may  be  called 
aesthetic  culture  is  but  the  highest  form  of  class  selfish- 
ness; that  such  practices  are  not  only  in  themselves 
vicious,  but  tend  to  the  lowering  of  the  whole  educational 
fabric;  that  the  underlying  thought  in  education  is  the 
teaching  how  to  think  and  the  meaning  of  study,  and 
this  much  at  least  is  due  to  the  masses;  that  it  is  those 
things  which  tend  most  to  the  useful  arts,  to  the  alle- 
viation of  human  suffering,  to  the  broadening  of  tlie  popu- 
lar horizon,  for  which  we  must  all  strive.  All  this,  trite 
enough  in  these  days,  was  not  an  old  thought  thirty-seven 
years  ago,  even  to  the  distinguished  scholars  who  formed 
his  audience;  and  the  teachings  of  Froebel  had  not  yet 
been  accepted  among  us. 

Then  glancing  rapidly  back,  Bigelow  said,  "  The  wis- 
dom of  the  ancients  was  selfish  in  its  privileges,  inwrought 
with  error,  superstition,  and  vice;  confined  to  a  ver}^ 
few;  inoperative  and  useless  to  the  masses;  it  did  not 
and  could  not  advance  any  vast  public  and  improving  in- 
terests, nor  conserve  social  prosperity  and  order." 

Speaking  of  the  Renaissance,  he  remarks,  in  a  para- 


XIX.  CENTURY.     EARLY    PHYSICIANS.     327 

graph  full  of  interest,  that  the  popular  idea  of  this  bril- 
liant epoch  as  a  revival  of  classical  learning  merely  is 
untrue.  That  the  study  of  the  classics  was  but  one  evi- 
dence of  the  reviving  and  wide-spread  interest  in  intel- 
lectual pursuits.  Literature,  the  arts,  science,  all  shared 
equally  in  the  new  advance ;  and  of  them  all,  science  soon 
began  to  cut  for  itself  a  broad,  new,  and  straight  path. 

How  large  an  influence  these  discourses  of  Bigelow  had 
upon  modern  thought  and  purpose  it  is  difficult  to  say. 
Doubtless  he  was  one  of  many ;  but  to  us  the  interesting 
thing  is  this:  that  such  teaching,  vigorous,  forceful,  was 
but  the  continuation  of  the  lessons  of  a  long  life;  for 
eighty  years  he  had  been  a  modern.  Grasping  the  mean- 
ing of  science  in  his  youth,  he  had  held  it  steadily  before 
him.  And  now  we  see  him  nearing  the  end  of  his  career, 
preaching  and  teaching  among  the  most  radical  thinkers ; 
old  as  he  was,  leading  the  advance  in  the  great  educational 
reform  of  our  time.  Never  senile,  never  looking  back- 
ward, but  always  confident  of  better  things  to  come. 

These  educational  essays  caused  wide-spread  discus- 
sion, both  at  home  and  abroad,  when  they  came  to  be 
distributed.  The  historian,  Lecky,  wrote  from  Italy  a 
strong  and  interesting  letter  of  dissent;  but  Lyell,  Hux- 
ley, Spencer,  and  other  liberal  Englishmen  were  vigorous 
in  their  commendations.  The  essays,  under  the  title 
"  Modern  Inquiries,"  were  published  at  the  time  of  a  for- 
ward educational  movement  in  England. 

Lyell  writes  to  Bigelow,  "  Our  universities  and  all  the 
principal  schools  are,  as  you  know,  in  the  hands  of  the 
clergy;  hence  we  shall  have  more  difficulty  than  you  in 
introducing  the  elements  of  science  and  natural  history. 
The  clergy — Romanist,  Anglican,  and  Dissenting — have 
hitlierto  proved  too  strong  for  us.  Reformers  and  Amer- 
ican and  Continental  rivalry  must  be  brought  to  bear 
before  we  shall  succeed.  Your  book  will  be  most  useful 
at  this  moment  in  this  country." 


328  MEDICINE    IN   AMERICA. 

"  By  their  fruits  ye  shall  know  them"  is  sometimes 
true.  It  is  true  in  Bigelow's  case.  It  is  fair  to  say  that 
the  Massachusetts  Institute  of  Technology,  with  its  splen- 
did curriculum,  its  strong  staff,  its  host  of  highly  trained 
and  successful  graduates,  stands  to-day  a  monument,  in 
part  at  least,  to  the  energies  of  this  distinguished  man. 

That  work  for  educational  reform  was  Jacob  Bigelow's 
last  great  work.  He  did  many  other  things  in  his  de- 
clining years, — pleasant  things,  to  be  remembered  by  his 
friends.  He  became  the  Old  Man  Oracle, — a  Nestor 
most  distinguished,  most  approachable,  of  whom  one 
hears  to-day  nothing  but  good.  It  was  a  busy  old  age, 
given  for  a  time,  more  than  is  the  wont  with  Nestors,  to 
travel  and  intercourse  with  men.  When  eighty-three  he 
went  to  California  on  a  pleasure-trip,  with  wife  and 
friends;    and  of  the  wonders  there  he  explored  many. 

In  old  age,  too,  he  amused  himself  much  with  playful 
writings,  extra-professional,  the  best  known  of  which  was 
Xjjvwdta  ("  ChenodiSi") — a  classical  Mother  Goose,  the 
ditties  of  that  good  dame  rendered  into  Greek  and  Latin. 

A  pretty  collection  is  AloXo?  Uoisffc?  ("Various  Po- 
etry"), a  volume  of  fugitive,  humorous  poems,  attached 
to  which  are  the  names  of  well-known  writers,  his 
friends :  Bryant,  Longfellow,  Holmes,  Emerson,  Lowell, 
and  others. 

In  such  and  other  pleasantries  he  passed  his  declining 
days — not  in  harness,  a  garb  scarce  suited  to  ninety-two. 
Blind  at  the  last,  for  nearly  five  years.  Bedridden,  but 
with  mind  undimmed.  Much  sought  out,  even  so.  Un- 
forgotten  to  the  very  end,  though  long  inactive  among 
us.    The  story  fades  away  gently — the  history  remains. 


CHAPTER    XT  I. 

THE    NINETEENTH    CENTURY.       CHAPMAN,    FRANCIS, 
GIBSON,    JACKSON. 

Philadelphia  and,  later.  New  York  being  the  cen- 
tres of  medical  interest  as  well  as  of  population  for  very 
many  years  of  our  history,  drew  to  themselves  great 
numbers  of  able  men  from  other  parts  of  the  country. 
For  this  reason  probably,  with  a  few  exceptions,  such 
as  Long,  of  Georgia,  and  McDowell,  Dudley,  and  Drake, 
of  Kentucky  and  Ohio,  we  hear  little  of  distinguished 
Southern  or  Western  doctors  in  the  first  half  of  the  nine- 
teenth century.  The  large  Eastern  cities  appropriated 
the  most  eminent  physicians  from  the  whole  country. 

There  is  no  better  example  of  this  than  Nathaniel 
Chapman,  of  Virginia  and  Philadelphia.  Wherever  he 
had  lived  he  would  undoubtedly  have  been  a  national 
figure,  but  he  chose  to  live  in  Philadelphia.  He  would 
have  been  a  national  figure  because  he  was  roused  by 
Sydney  Smith's  slur  at  the  insignificance  of  American 
achievement,  and  he  determined  that,  if  he  could  help 
it,  American  medical  literature  should  be  rescued  from 
the  sink  in  which  the  captious  Scotchman  had  placed  it. 

''  In  the  four  quarters  of  the  globe,  who  reads  an 
American  book?  What  does  the  world  yet  owe  to  an 
American  physician  or  surgeon?"  was  what  Smith  had 
said.  Chapman  took  this  motto  and  made  it  his  own  for 
The  Philadelphia  Journal  of  the  Medical  and  Physical 
Sciences, — that  venerable  periodical  which  is  known  to- 
day as  The  American  Journal  of  the  Medical  Sciences. 

Like  many  other  American  physicians  of  whom  we 
read,  Nathaniel  Chapman  was  descended  from  an  ancient 
and  honorable  English  family.    The  Chapmans  were  long 

329 


33>o 


MEDICINE    IN    AMERICA. 


settled  in  Virginia,  on  the  Pamunkey  River.  He  was 
born  in  Virginia  on  his  father's  estate  in  Fairfax  Comity, 
on  the  Potomac,  near  Alexandria.  The  date  was  May 
28,  1780,  and  it  is  an  interesting  fact  that  his  lifelong 
friend  and  professional  associate,  Joseph  Hartshorne,  was 
born  in  Alexandria  the  year  previous. 

At  the  Alexandria  Academy,  founded  by  Washington, 
the  two  lads  studied  for  six  years.  They  seem  to  have 
been  good  boys  and  studious,  for  we  hear  nothing  but 
pleasant  things  of  them  there,  such  as  warm  the  hearts 
of  parents  and  guardians.  Chapman  was  made  a  good 
Latinist,  at  any  rate,  and  came  to  love  literature  with  a 
warmth  and  discrimination  which  remained  with  him 
through  life. 

When  seventeen  years  old  he  began  the  study  of  medi- 
cine. It  was  in  1797,  one  of  the  famous  yellow  fever 
years  made  memorable  by  the  writings  of  Rush,  that 
Chapman  came  to  Philadelphia  and  entered  the  Pennsyl- 
vania School. 

Besides  an  excellent  education  in  the  classics  and  two 
years  desultory  reading  of  medical  books,  Qiapman  had 
few  advantages  to  assist  him  in  his  new  life.  He  was  a 
stranger,  poor,  without  acquaintance  or  introduction ;  but 
from  the  first,  even  as  a  lad,  he  found  himself  surrounded 
by  friends.  His  delightful  personality  was  the  best  part 
of  his  youthful  capital.  He  was  a  good  fellow;  pleasant 
to  gaze  upon,  unaffected,  sincere,  clear-eyed,  warm- 
hearted, and  brilliant.  He  made  powerful  friends  by  his 
graciousness  and  held  them  by  his  sterling  abilities.  So 
he  became  prominent  while  young,  and  his  subsequent 
conduct  justified  the  men  who  had  helped  him. 

That  erratic  physician,  Charles  Caldwell,  had  come 
from  North  Carolina  to  Philadelphia  about  five  years 
before  Chapman's  debut,  and  it  was  with  him  that  the 
latter  soon  found  himself  in  active  rivalry,  when  the  two 
young  men  were  well  launched.     We  read  that,  when  a 


XIX.  CENTURY.     CHAPMAN. 


331 


student  on  the  benches  of  Rush's  lecture-room,  Caldwell 
proclaimed  his  intention  never  to  be  satisfied  until  he  was 
seated  in  the  lecturer's  chair  or  one  equal  to  it.  But  he  was 
fated  to  miss  his  mark  some  few  years  later,  and  so  keen 
and  bitter  was  his  disappointment  that  he  threw  up  his 
practice  and  chances,  abandoned  Philadelphia,  and  betook 
himself  to  that  Western  School  where  he  afterwards  hec- 
tored and  opposed  his  more  famous  colleague,  Daniel 
Drake. 

Be  it  observed  of  this  active-minded  Caldwell,  in  pass- 
ing, that  he  was  a  thorn  in  the  flesh  of  most  folk  with 
whom  he  came  in  contact.  Rush  himself  did  not  escape 
his  censures,  as  Caldwell's  Autobiography  shows, — a 
somewhat  absurd  production, — and  the  latter  never  for- 
gave Chapman  for  winning  a  prize  which  he  had  marked 
for  his  own.  He  wrote  of  this  episode,  "  Chapman  had 
the  candor  to  acknowledge  that  he  was  more  indebted 
to  the  friendships  of  the  Trustees  than  to  any  other 
cause,"  and  that  "  the  Chair  was  bestowed  on  my  com- 
petitor from  the  good  will  and  favor  of  the  Board  of 
Trustees,  notwithstanding  the  almost  universal  admis- 
sion that  my  own  qualifications  for  it  were  not  a  little 
superior."  Here  surely  was  an  American  without  a  sense 
of  humor.  So  much  for  Caldwell,  of  whom  nothing 
further  need  be  said,  save  that  he  was  forever  appearing 
in  the  periodical  literature  of  those  days.  Always  bump- 
tious and  loud,  though  with  many  lucid  moments,  we  can- 
not escape  him  if  we  ask  about  medical  times  of  a  cen- 
tury ago. 

Chapman  was  the  antipodes  of  Caldwell,  so  the  one 
was  taken  and  the  other  left  Philadelphia ;  but  before 
that  Chapman  had  spent  many  fruitful  years  in  the  city. 
On  his  entering  the  University  School  he  had  become 
a  private  pupil  of  Rush,  who  ever  afterwards  loved  him 
well. 

The  popular  young  fellow  was  graduated  in  the  spring 


33^ 


MEDICINE    IN    AMERICA. 


of  1800,  and  presented  a  thesis  on  hydrophobia  in  which 
he  defended  certain  favorite  propositions  of  Rush  on  the 
subject.  He  had  previously  written  an  essay  on  the  sym- 
pathetic connections  of  the  stomach  with  the  rest  of  the 
body.  This  paper,  which  was  read  later  before  the  Phila- 
delphia Medical  Society,  contained  the  germs  of  the 
writer's  doctrines  regarding  the  pathology  of  fever  as 
well  as  of  the  modus  operandi  of  medicines, — matters 
which  need  no  further  mention  here. 

Then  he  went  abroad  for  three  years  and  employed 
himself  well  in  the  prevailing  fashion.  He  seems  to  have 
been  a  good  deal  of  a  social  lion  in  Edinburgh,  where  he 
was  taken  up  by  Lord  Buchan,  Dugald  Stewart,  and 
Brougham. 

The  story  is  told  that  Buchan,  an  eccentric  but  kindly 
enthusiast  and  a  friend  of  America,  gave  him  a  public 
breakfast  just  before  he  sailed  for  home,  and  that  he 
invited  to  meet  him  most  of  the  wits  and  distinguished 
persons  of  the  town.  It  was  on  Washington's  birthday. 
It  seems  that  Buchan  had  had  a  warm  friendship  for  that 
great  man,  to  whom,  some  years  before,  he  had  given  a 
box  made  from  the  wood  of  W^allace's  oak,  with  the  re- 
quest that  at  his  death  he  should  bequeath  it  to  the  man 
in  his  own  country  who  seemed  most  worthy  of  it.  Natu- 
rally, Washington  had  avoided  the  invidious  situation, 
and  by  will  returned  the  box  to  Buchan.  So  the  latter 
now  bestowed  it  upon  Chapman,  with  the  intention  that 
eventually  it  should  go  to  the  Cabinet  of  Washington  Col- 
lege, which  Washington  had  promoted. 

Altogether,  that  breakfast  was  a  repast  long  to  be 
remembered  by  the  young  man. 

In  1804  Chapman  settled  in  Philadelphia  and  began 
to  practise  medicine.  He  was  then  but  twenty-four  years 
old,  and,  if  we  are  to  credit  his  biographer,  his  success 
was  immediate.  As  that  writer  puts  it,  "  for  a  period 
of  nearlv  fiftv  years  he  commanded  whatever  he  could 


XIX.  CENTURY.     CHAPMAN.  333 

attend  of  practice  in  the  most  refined  and  opulent  circles 
of  our  city."  He  was,  however,  something  more  than  a 
mere  fashionable  doctor.  His  fame  does  not  rest  on  that 
and  the  Edinburgh  breakfast,  but  on  his  teaching  and 
writing,  and  in  those  lines  he  did  most  admirable  work. 

First,  in  1804,  as  a  teacher  of  obstetrics,  he  was  made 
the  assistant  of  Professor  Thomas  C.  James  in  the  Uni- 
versity School.  Then,  in  181 3,  on  the  death  of  Rush, 
when  the  chair  of  Theory  and  Practice  was  left  vacant, 
Barton  was  transferred  to  it  and  Chapman  was  given 
Barton's  former  professorship  of  Materia  Medica.  He 
occupied  the  place  for  three  years  and  did  some  excellent 
teaching  and  original  writing.  His  collected  lectures, 
under  the  title  "  Elements  of  Therapeutics  and  Materia 
Medica,"  were  called  by  his  admirers  the  best  treatise  on 
those  subjects  in  the  English  language.  Fortunately,  the 
methods  which  he  advocated  quickly  became  antiquated, 
and  Chapman  himself  suppressed  a  later  edition.  Those 
were  the  days  of  heroics  in  dosing,  and  early  in  life  Chap- 
man showed  no  such  wisdom  as  did  his  distinguished 
senior,  Nathan  Smith,  regarding  the  nostrums  of  the 
time.  But  one  may  still  read  with  interest  and  pleasure 
his  two  prefatory  chapters  on  the  "  History  and  Improve- 
ments of  the  Materia  Medica." 

Chapman  was  an  easy  writer,  free  from  pedantry, 
though  of  extensive  learning,  especially  in  the  ancient 
classics,  and  his  description  of  the  effect  of  strong  mental 
impressions  on  the  sick  is  very  striking.  In  one  para- 
graph he  remarks,  "  Disease,  as  has  justly  been  said, 
depresses  the  powers  of  the  understanding  as  well  as  the 
vigor  of  the  corporeal  frame,  and  depraves  the  judgment 
as  well  as  the  processes  of  digestion.  He  who  is  sick  is 
extremely  credulous  as  to  the  object  of  his  hopes  and 
fears,  so  that  it  too  often  happens,  that  whoever  assures 
him  of  health  easily  obtains  his  confidence  and  he  soon 
becomes   the   dupe  of  quacks   and   ignorant  pretenders. 


334  MEDICINE    IN   AMERICA. 

But  the  vulgar  gaze  and  the  emotions  which  it  excites 
are  aHke  evanescent,  and  all  experience  attests  that  solid 
reputation  and  permanent  success  in  medicine,  as  in  other 
pursuits,  are  the  rewards  only  of  superior  merit  and  un- 
usual acquisitions." 

However,  it  was  not  as  a  teacher  of  obstetrics  or  thera- 
peutics that  Chapman  acquired  his  great  reputation,  but 
in  the  chair  of  Theory  and  Practice  of  Medicine  and 
Clinical  Medicine,  which  he  held  for  more  than  a  third 
of  a  century. 

He  had  been  the  Professor  of  Therapeutics  for  only 
three  years,  when,  in  1816,  on  the  death  of  his  friend 
Barton,  he  became  his  successor.  Chapman  was  thirty- 
six  years  old  when  he  was  called  to  lecture  on  theory  and 
practice.  It  was  the  position  for  which  he  was  specially 
qualified,  and  until  1850,  when  he  resigned,  he  made  it 
one  of  the  strongest  chairs  in  the  School.  Rush  had  been 
chosen  for  the  same  place  in  1789;  so  that,  except  for 
the  short  episode  of  Barton,  those  two  men — Rush  and 
Chapman,  master  and  pupil — held  it  for  more  than  sixty 
years. 

There  are  some  few  men  still  active  among  us  who 
remember  Chapman's  teaching  in  his  old  age,  and  they 
bear  loyal  witness  to  his  ability  and  charm.  He  was 
"  self-possessed,  deliberate,  and  emphatic,"  says  one  who 
knew  him  well.  "  Whenever  warmed  with  his  subject, 
his  animation  became  oratorical.  Often  the  tedium  of 
dry  matter  would  be  enlivened  by  some  stroke  of  wit, 
a  happy  pun,  an  anecdote  or  quotation.  He  was  fur- 
nished with  stores  of  facts  and  cases  drawn  from  his 
own  large  experience  and  observation,  illustrating  the 
principles  of  the  disease  or  treatment  under  discussion. 
His  bearing  was  dignified,  his  manner  was  ea.sy,  and  his 
gestures  were  graceful." 

It  is  needless  here  to  rehearse  Chapman's  theories  of 
the  nature  of  disease.      They   differed   somewhat   from 


XIX.  CENTURY.     CHAPMAN.  335 

those  of  Rush,  but  possessed  Httle  originaHty,  mainly  fol- 
lowing lines  familiar  in  his  time.  Virchow  had  not  then 
made  himself  heard  and  the  manifold  theories  of  the  day 
had  not  yet  given  place  to  fact  and  knowledge.  But 
Chapman  held  his  high  position,  through  all  those  years, 
without  an  enemy,  and  resigned  only  when  age  and  fail- 
ing health  made  further  service  impossible.  To  our  mod- 
ern thinking,  he  served  too  long;  but  even  at  the  end 
his  retirement  was  universally  regretted. 

The  personality  of  the  man  made  a  great  impression 
on  the  Philadelphia  of  our  grandfathers.  He  was  always 
jovial,  gay,  and  witty.  As  he  grew  old  the  habit  of 
punning  increased  upon  him :  that  atrocious  habit  so 
grievous  to  twentieth-century  ears.  -His  jokes  and  his 
sayings  were  familiar  to  all  the  town,  and,  like  the  man 
himself,  had  only  to  be  mentioned  to  provoke  the  cheerful 
smile. 

Now,  it  is  not  for  his  practice,  his  preaching,  or  his 
punning  that  we  must  remember  Nathaniel  Chapman; 
but  because  of  his  conception  of  medical  journalism  and 
the  impulse  he  gave  it  through  many  laborious  years. 

In  1820  Mathew  Carey,  a  prominent  publisher  of  books 
in  Philadelphia,  conceived  the  idea  of  establishing  a  medi- 
cal periodical  of  broad  scope;  he  secured  the  willing  ser- 
vice of  Chapman  as  editor,  and  the  enterprise  was 
launched  under  the  title  The  Philadelphia  Journal  of  the 
Medical  and  Physical  Sciences.  For  four  years  Chapman 
alone  acted  as  editor,  but  in  1824  he  took  as  his  asso- 
ciates William  P.  Dewees  and  John  L.  Godman.  From 
the  outset  this  publication  was  very  successful,  and  its 
editor  to-day,  tracing  its  history  through  nearly  eighty- 
five  years,  points  to  a  long  series  of  many  of  the  most 
important  articles  that  have  come  from  the  pens  of  Ameri- 
can medical  writers.  In  1827  the  title  of  the  publication 
was  changed  to  that  by  which  we  now  know  it, — The 


336  MEDICINE    IN    AMERICA. 

American  Journal  of  the  Medical  Sciences, — and  in  the 
same  year  Isaac  Hays  was  added  to  the  staff. 

A  few  years  ago  there  appeared  in  that  periodical  an 
article  entitled  "  The  History  of  the  Development  of 
Medical  Science  in  America  as  recorded  in  the  American 
Journal  of  the  Medical  Sciences."  Though  but  a  frag- 
mentary history,  it  shows  how  useful  a  position  a  well- 
conducted  medical  journal  may  hold.  Perhaps  the  Jour- 
nal owes  more  to  Hays  than  to  Chapman.  Be  that  as  it 
may,  the  fact  remains  that  the  elder  man  established  it, 
that  he  gave  it  the  foundation  and  policy  by  which  it  has 
lived  and  flourished,  and  that  eighty  years  ago  he  was 
the  leading  medical  editor  of  America. 

Another  important  undertaking  of  Chapman  was  the 
Medical  Institute  of  Philadelphia,  sometimes  known  as 
the  Summer  School,  which  he  founded  in  1817.  It  was 
intended  not  only  for  undergraduate  students,  but  was  of 
great  value  as  a  training  school  for  teachers,  and  may  be 
considered  the  first  post-graduate  school.  Its  ideal  was 
a  high  one,  and  for  many  years  nothing  like  it  was  to  be 
found  on  this  side  of  the  Atlantic. 

Again,  were  it  not  for  too  great  digression,  it  would 
be  interesting  to  look  more  at  length  at  some  of  the  men 
who  made  it  famous,  such  as  W.  P.  Horner,^  the  anato- 
mist and  histologist ;  W.  P.  Dewees,^  the  writer  on  chil- 
dren's diseases ;  Samuel  Jackson ;  J.  K.  Mitchell :  John 
Bell ;  H.  L.  Hodge,  the  distinguished  gynaecologist ;  and 
W.  W.  Gerhard,  perhaps  the  most  notable  of  all.^ 


'Horner,   1793-1853;    Dewees,   1768-1841. 

^ "  W.  W.  Gerhard  (1809-72)  was  a  native  of  Philadelphia  and  a 
graduate  of  the  University  of  Pennsylvania.  After  taking  his  de- 
gree he  spent  two  years  in  Paris,  and  became  thoroughly  indoc- 
trinated with  the  teachings  of  Louis.  On  his  return  to  Philadelphia, 
he  was  appointed  lecturer  at  the  Medical  Institute  and  Assistant 
Clinical  Lecturer  to  Professor  Samuel  Jackson.  For  twenty-five 
years  he  was  the  Senior  Physician  to  the  Pennsylvania  Hospital. 
Some  of  his  clinical  lectures  appeared  in  the  Medical  Examiner,  of 


XIX.  CENTURY.     CHAPMAN.  337 

Nathaniel  Chapman  did  a  great  many  other  things  of 
which  it  would  be  pleasant  to  tell  in  season.  He  was  the 
centre  of  a  great  circle  of  medical  friends.  Indeed,  the 
story  of  Chapman  and  his  associates  would  include  a  large 
part  of  the  medical  history  of  America  for  half  a  century. 
He  was  a  busy  man,  but  not  so  fierce  a  worker  as  Rush; 
he  published  several  books  and  many  essays.  He  went 
so  far  abroad  in  his  early  days  as  to  edit  a  series  of  five 
octavo  volumes,  entitled  "  Select  Speeches,  Forensic  and 
Parliamentary,"  and  persons  were  found  to  read  them. 

When  the  biographers  tell  of  him  they  quote  the  rhymes 
that  J.  K.  Mitchell  sent  him :  nine  pleasant  stanzas  after 
the  manner  of  Robert  Burns.     Here  are  two  of  them : 

"  They  little  ken  ye,  wha  hae  known 
Y'er  science  and  y'er  skill  alone, 

Though  they  are  mair  than  ample; 
The  racy  pun,  rich  repartee. 
The  gushing  joke  frae  malice  free. 

Wad  na  complete  the  sample. 

"  But  better  far,  a  heart  that  ne'er 
Did  o'er  a  human  ill  forbear 

To  heave  a  feeling  sigh, 
That  readily  forgave  a  foe. 
And  never  dealt  a  jealous  blow. 
In  keenest  rivalry." 

The  fine  old  man  died  on  July  i,  1853,  in  his  seventy- 
fourth  year.  Three  years  before  that  he  had  laid  aside 
his  w^ork,  though  his  friends  still  sought  him,  and  to  this 


which  he  was  one  of  the  editors.  His  principal  work  was  his 
'  Treatise  on  Diagnosis  of  Diseases  of  the  Chest,'  Philadelphia, 
1842."     (Billings.) 

But  he  will  be  remembered  longest  as  the  first  man  to  distinguish 
clearly  the  differences  between  typhus  and  typhoid  fevers.  Edwin 
H.  Clarke  says  of  him,  "  The  merit  of  having  decided  this  important 
question,  of  having  demonstrated  the  essential  difference  between 
typhus  and  typhoid  fever,  belongs  chiefly,  if  not  wholly,  to  Dr.  Ger- 
hard, and  so  far  redounds  to  the  honor  of  American  medicine." 

22 


338  MEDICINE    IN    AMERICA. 

day  he  is  remembered  in  Philadelphia  as  a  central  figure 
in  that  city  of  great  traditions. 

There  lived  in  New  York  a  contemporary  of  Chapman, 
in  certain  respects  much  such  another  as  he, — John  W. 
Francis.  He  was  so  prominent  a  figure  there  for  nearly 
half  a  century  that  one  finds  it  impossible  to  pass  him  by 
with  a  mere  word,  though  as  a  man  of  science  he  con- 
tributed little  of  permanent  value  to  American  medicine. 
Valentine  Mott  delivered  a  eulogy  on  him  before  the 
Academy  of  Medicine,  and  if  we  are  to  accept  what  was 
there  spoken,  the  man's  having  lived  and  worked  among 
us  shed  a  lustre  on  practice  and  deserve  recording. 

Francis  was  humbly  born,  and  was  apprenticed  to  a 
printer  in  his  youth.  In  that  he  used  to  compare  himself 
to  Benjamin  Franklin.  Indeed,  the  good  man  went 
further,  and  took  a  harmless  pride  in  thinking  that  he 
resembled  the  shrewd  philosopher  in  appearance.  He 
made  him  his  hero,  and  one  of  his  best-known  essays 
is  an  estimate  of  the  great  Philadelphian  read  before  the 
New  York  Historical  Society.  Francis's  father  was  a 
German  immigrant,  a  grocer  by  vocation,  and  the  son 
was  born  on  Warren  Street,  New  York,  on  November 
17,  1789.  The  lad  had  slight  schooling,  though  he 
worked  hard  at  what  came  to  him,  and  at  an  early  age 
was  bound  to  George  Long,  a  well-known  printer  and 
publisher  of  the  time,  to  learn  his  trade.  It  is  said  that 
he  had  already  shown  a  taste  for  literature,  and  adopted 
the  printer's  calling  with  an  idea  that  it  would  help  him 
in  that  direction.  He  was  soon  undeceived,  for  he  found 
the  composing-stick  and  the  press  little  stimulating  to 
mental  growth;  but  he  was  not  daunted.  To  make  up 
for  lost  time  he  began  the  study  of  Latin  in  his  intervals 
of  work,  and  made  his  lunch  of  apples  while  he  read  his 
grammar  under  the  press.  Before  long  his  master  be- 
came convinced  that  his  apprentice  was  wasting  the  time 
of  both  in  such  tasks,  and  set  him  free  to  follow  his  fan- 


XIX.  CENTURY.     FRANCIS.  339 

cies  elsewhere.  Those  fancies  seem  always  to  have  led 
him  to  literature  rather  than  to  science,  and  just  why 
he  took  up  medicine  does  not  appear  clearly,  unless  it  was 
as  a  side  issue  or  by-product  of  the  study  and  making  of 
books.     Yet  he  became  a  good  doctor. 

His  mother's  circumstances  appear  to  have  been  com- 
fortable at  this  time,  for  he  was  able  to  fit  himself  for 
college  at  her  expense,  and  was  graduated  from  Columbia 
in  1809,  at  the  age  of  twenty.  Previous  to  his  graduation, 
however,  like  Hosack  before  him,  he  began  the  study  of 
medicine,  and  was  entered  as  a  student  in  Hosack' s  office 
two  years  before  taking  his  Bachelor's  degree. 

In  spite  of  his  leanings  towards  literature,  Francis  was 
no  amateur  at  his  professional  work.  Eventually  he  made 
that  the  leading  thought  of  his  life,  and  used  literature  as 
a  hand-maiden  to  it.  One  often  wonders  why  this  excel- 
lent association  is  not  more  common.  Among  the  great 
scientists  of  Europe  in  former  generations  it  was  fre- 
quently seen,  and  in  our  own  times  some  great  men  have 
demonstrated  its  value.  Most  assuredly  the  articulate 
goes  further  than  the  inarticulate,  as  Tyndall  long  ago 
told  us.  Huxley  would  never  have  become  the  popular 
prophet  of  science  without  his  delightful,  pungent  style, 
and  Virchow's  great  intellect  would  never  have  won  in- 
stant and  universal  acknowledgment  had  it  not  clearly 
and  cogently  found  voice.  Few  of  the  truly  great  men 
of  science  have  failed  to  see  the  value  of  a  lucid  and  famil- 
iar style,  although  it  is  the  fatuous  conviction  of  the 
second-rate  that  obscure,  technical  pomposity  is  the 
essence  of  scientific  diction.  Francis  appreciated  all  this 
as  much  as  did  Oliver  Wendell  Holmes  or  S.  Weir 
Mitchell ;  and  although  he  never  composed  a  story  or  a 
rhyme,  he  did  acquire  a  pleasant,  spirited  fashion  of 
writing  which  causes  his  essays  of  nearly  a  hundred  years 
ago  to  be  read  still  without  a  yawn. 

So  Francis  entered  Hosack's  office  as  a  student  in  1807, 


340  MEDICINE    IN    AMERICA. 

was  graduated  from  the  new  College  of  Physicians  and 
Surgeons  in  1811,  and  upon  receiving  his  diploma  was 
immediately  taken  into  partnership  by  the  elder  man. 
Even  before  his  graduation  he  had  become  a  great  favor- 
ite with  Hosack,  who  came  to  lean  on  him  for  many 
things;  among  others,  as  a  tutor  to  the  students  and  as 
his  representative  in  the  sick-room.  Indeed,  the  lad's 
judgment  was  so  sound  and  his  knowledge  so  human  and 
so  broad  that  Hosack  used  to  say  that  as  a  medical  con- 
sultant he  preferred  him  to  any  of  his  own  contemporaries. 

In  18 10  Hosack  established  his  Medical  and  Philo- 
sophical Register.  He  was  stimulated  to  this  venture 
largely  by  the  enthusiasm  of  young  Francis,  for  here  was 
the  latter's  chance  in  medical  literature.  Up  to  1814  the 
periodical  was  published  anonymously,  but  in  that  year 
a  new  edition  of  the  work  up  to  that  date  was  issued,  and 
Francis's  name  appeared,  joined  with  Hosack's,  on  the 
title-page.  In  181 3  the  former  had  been  appointed  Pro- 
fessor of  the  Institutes  of  Medicine  and  Materia  Medica 
in  the  newly  organized  faculty  of  the  College  of  Physi- 
cians and  Surgeons,  so  that  he  wrote  himself  Professor 
in  the  new  book,  although  he  was  but  twenty-five  years 
old.  He  had  found  a  chair  as  early  as  had  Rush,  and 
in  the  year  of  the  latter's  death. 

So  one  may  see  how  all  those  men  of  whom  we  are 
reading  hung  together  and  overlapped  and  corresponded 
with  and  consulted  one  another.  The  front  benches  of 
American  medicine  were  not  crowded  a  hundred  years 
ago.  There  was  no  close  corporation,  for  such  a  thing 
is  impossible  in  science,  despite  the  hysterics  of  certain 
modern  penny-a-liners ;  but  there  were  few  well-cultivated 
men,  and  such  as  there  were  sought  one  another.  We 
have  noted  Hosack  and  Rush  exchanging  letters  of  formal 
but  kindly  intimacy,  beginning  with  "  Dear  Sir,"  and 
subscribed  "  Your  obet,  humble  Servant."  Here  was 
Hosack's  pupil  and  youthful  partner  editing  a  journal, 


XIX.  CENTURY.     FRANCIS.  341 

holding  a  professorship,  and  making  observations  in 
pathology  which  may  still  be  read  with  profit.^ 

The  four  volumes  of  the  Register  are  full  of  a  great 
variety  of  information,  and  their  delightful  tone  is  due 
in  considerable  part  to  Francis's  keen  discrimination. 
Besides  the  collection  of  pathological  communications, 
one  finds  biographical  notices  of  distinguished  doctors, — 
notices  invaluable  now  to  the  medical  historian, — essays 
on  Climate,  on  Agriculture,  on  Canals,  on  Coal  Deposits, 
on  the  Falls  of  the  Ohio,  on  the  Height  of  Mountains  in 
Virginia  and  New  York,  on  Steam-Carriages  (1810),  on 
Moral  and  Political  Philosophy,  on  Fishes,  on  the  Col- 
lections of  the  New  York  Historical  Society,  on  the  State 
of  Medicine  in  America,  its  Hospitals,  Schools,  Curricula, 
and  on  a  hundred  other  topics  of  scientific  and  general 
interest. 

The  reading  of  those  books,  as  much  as  any  writings 
then  current,  puts  one  in  intimate  touch  with  the  best 
thought,  the  conditions,  and  the  progress  of  the  times. 

Francis's  career  as  a  teacher  was  not  long-,  but  it  was 
far  from  being  obscure.  He  was  a  graceful  talker,  al- 
though to  his  audience  he  appeared  at  first  as  a  short, 
stout  man  with  an  ungainly  figure.  But  his  traditions 
were  good  and  he  had  inherited  all  Hosack's  enthusiasm 
for  the  uplifting  of  the  profession.  So  he  became  a  popu- 
lar lecturer;  and  while  he  developed  no  new  theories  and 
founded  no  new  school  of  thought,  his  benches  were 
always  crowded  and  he  held  the  classes  in  absorbed 
attention. 


*  In  the  first  volume  of  the  Register,  p.  35,  there  is  a  report  by 
Francis  of  a  case  most  interesting  to  surgeons  to-day.  He  calls  it  a 
"  Case  of  Enteritis,  accompanied  with  a  preternatural  formation  of 
the  ileum."  It  is,  in  fact,  an  account  of  a  patient  who  died  of  an 
acute  septic  peritonitis,  due  to  strangulation  of  the  ileum  by  a 
Meckel's  diverticulum,  coincident  with  an  appendicitis.  The  report 
is  illustrated  with  a  beautifully  executed  wood-cut  of  the  organs, 
designed  by  a  medical  student,  Mr.  Inderwick. 


342  MEDICINE    IN   AMERICA. 

From  the  outset,  too,  he  gathered  and  maintained  a 
large  paying  practice,  although  his  good-heartedness 
never  shirked  the  calls  of  the  poor.  Indeed,  so  long  as 
he  lived  he  was  a  fine  type  of  Thackeray's  beloved  Doctor 
Goodenough,  and  his  carriage  might  be  seen  at  night  in 
the  tenement  alleys  as  often  as  before  the  Bleecker  Street 
fronts.  It  was  said  that  at  his  funeral  a  most  touching 
sight  was  the  stream  of  ragged  and  forlorn  humanity 
which  followed  his  coffin. 

The  twenty  years  of  his  life  after  i8i  i  were  his  busiest 
ones.  Up  to  1820  he  was  incessantly  occupied  with  teach- 
ing, writing,  and  practising,  and  his  receipts  in  that  year 
were  fifteen  thousand  dollars, — a  very  large  sum  for  a 
young  man  but  nine  years  in  general  practice  in  a  small 
town,  such  as  New  York  then  was.  At  any  rate,  his  work 
broke  him  down,  so  that  he  had  to  go  to  Europe  for  a 
year, — an  experience  which  he  vastly  enjoyed.  That  was 
early  in  the  period  of  which  we  are  reading.  He  returned 
to  New  York  in  181 5,  was  at  once  appointed  Professor 
of  the  Institutes  of  Medicine  in  the  College  of  Physicians 
and  Surgeons,  and  two  years  later  added  to  his  duties 
the  chair  of  Medical  Jurisprudence.  In  18 19  he  added 
to  these  the  professorship  of  Obstetrics ;  so  that  he  had 
become  almost  as  many-sided  a  man  as  the  versatile 
Nathan  Smith. 

In  1826,  with  his  friends  Hosack,  Mott,  McNevin,  and 
Mitchell,  he  resigned  from  the  College  to  organize  that 
new  School  of  which  we  have  heard  the  brief  and  brilliant 
record, — Rutgers  Medical  College.  There  he  held  the 
chair  of  Obstetrics  and  Forensic  Medicine.  After  five 
years  came  the  end  of  that  institution  by  act  of  the  Legis- 
lature, and  with  its  collapse  Francis's  teaching  career 
ended.  He  was  but  forty-one  years  old,  and  the  remain- 
ing thirty  years  of  his  life,  although  busy  and  conspicuous 
in  his  community,  have  little  bearing  on  our  theme.  He 
died  on  February  8,  1861. 


XIX.  CENTURY.     GIBSON.  343 

There  was  a  remarkable  man  of  Baltimore  and  Phila- 
delphia,— William  Gibson.  Some  one  should  write  a  life 
of  him ;  there  is  abundant  material.  Entirely  aside  from 
his  services  to  science,  here  was  a  man  well  worth  know- 
ing. Scholar,  sportsman,  artist,  athlete,  musician,  trav- 
eller, genial,  accomplished  man  of  the  world,  and  delight- 
ful companion,  few  disciples  of  ^sculapius  in  this  or 
any  other  country  appeal  so  much  to  one's  sense  of  what 
an  all-around  man  should  be.  Doubtless  he  left  no  such 
great  mark  upon  American  medicine  as  did  others,  but 
let  us  learn  something  of  him  and  wish  for  more  of  his 
kind. 

In  the  first  place,  he  lived  eighty  years,  being  born  in 
Baltimore  in  1788  and  dying  in  Savannah  in  1868. 

He  came  of  a  well-to-do  family  and  his  father  was 
able  to  have  him  educated  liberally. 

Gibson's  Diary,  continued  through  more  than  sixty 
years,  tells  something  of  his  youth  and  early  days, — 
topics  made  very  live  and  interesting  by  his  kindly  pen. 
Those  years,  up  to  the  age  of  fifteen,  were  passed  in 
Baltimore  and  Annapolis.  He  went  to  the  College  in 
the  latter  place,  where  the  distinguished  Dr.  McDowell 
was  then  principal;  and,  graduating  thence,  entered  the 
Sophomore  Class  at  Princeton  in  1803. 

He  was  an  ingenious,  sprightly  lad,  full  of  waggeries 
and  vagaries,  of  humor,  ambition,  and  cleverness,  if  not 
genius,  and  having  a  keen  sense  of  the  fitness  of  things 
withal;  not  easily  led  away  by  words  and  titles  and  the 
names  of  men  in  high  places  and  other  pomposities. 
While  an  undergraduate  he  was  rather  out  of  favor  with 
the  authorities  as  we  might  suppose,  although  later  they 
came  to  love  him;  and  he,  grown  famous,  tells  merrily 
of  the  anecdotes  of  his  youth  which  his  old  pedagogues 
narrated. 

But  the  College  did  not  suffice  him  during  his  senior 
year.     He  must  be  otherwise  employed,  and  therefore 


344 


MEDICINE    IN   AMERICA. 


took  up  the  study  of  medicine  at  the  Pennsylvanian 
School.  That  was  in  1805,  when  he  was  seventeen  years 
old.  Here,  as  at  College,  his  refreshing  frankness  spoke 
out  on  occasion;  he  was  afraid  of  no  one,  and  sent  his 
gaping  comrades  shuddering  to  their  diaries  by  remark- 
ing of  Physick  that  before  long  he  expected  to  succeed 
the  old  man  as  professor.  The  lads  liked  that  sort  of 
thing,  but  it  frightened  them.  After  a  hundred  years 
our  young  medical  men  are  much  the  same,  scarcely 
daring  to  call  their  souls  their  own.  Some  rare  one  rises 
now  and  again,  but  he  breaks  no  spell  and  gains  no 
followers.  Gibson  did  not  gain  them,  nor  did  Henry  J. 
Bigelow,  who  much  resembled  him.  Young  men  win 
fame  in  literature  and  art ;  young  men  become  governors 
and  statesmen  and  leaders  of  armies  and  masters  of 
finance;  there  are  great  preachers  who  are  young,  and 
great  travellers  to  whom  their  learned  elders  listen  with 
respect ;  there  is  here  and  there  an  emperor.  The  world 
takes  note  of  them  and  of  the  things  they  are  doing  well. 
Such  men  speak  out  eagerly  without  fear,  sometimes 
without  reproach.  The  young  doctors  do  not.  At  least, 
they  are  mostly  silent  in  the  grave  and  decorous  Eastern 
States.  They  are  students,  plastic  and  docile,  while  their 
contemporaries  in  the  great  world  are  making  their 
voices  heard.  They  are  young  practitioners  wearily 
waiting  for  patients,  or  young  scientists  studying  and 
teaching  in  the  tracks  which  others  have  beaten,  until 
middle  age  overtakes  them,  while  their  old  college-mates 
are  being  made  presidents  and  steel  barons  and  railway 
kings. 

Is  it  because  ars  longa,  vita  hrevis  weighs  so  upon 
them?  Vita  hrevis,  indeed.  So  much  the  more  reason 
why  they  should  speak  out  in  season. 

At  any  rate,  Gibson  made  himself  heard  a  hundred 
years  ago,  and  to  what  purpose  will  appear.  He  did  not 
stay  long  in  Philadelphia,  studying  medicine.     In  1806 


XIX.  CENTURY.     GIBSON.  345 

he  received  his  bachelor's  degree  from  Princeton  College, 
and  left  for  Europe  for  a  four  years'  sojourn.  Of  course, 
he  went  to  the  old  familiar  places,  Edinburgh  and  Lon- 
don. The  first  three  years  were  given  to  Edinburgh, 
and  there  he  received  the  doctor's  degree  in  1809.  But 
he  studied  other  things  than  medicine,  though  that  occu- 
pied most  of  his  time.  John  Bell  was  his  master  in  sur- 
gery. With  Adam  and  Dalsell  he  devoured  the  Latin 
classics  and  the  works  of  the  great  moderns.  His  thesis 
"  De  forma  ossium  gentilitia"  is  readable. 

In  1809  he  went  to  London,  where  he  followed  Sir 
Charles  Bell,  who  became  his  friend.  He  also  came  to 
know  well  Cooper  and  Abernethy.  In  after-years  he 
used  often  to  talk  about  those  heroes  of  his  youth,  but 
he  always  thought  best  of  Bell.  "  Cooper,"  he  said, 
"  was  a  great  man,  but  he  did  not  possess  the  ability  of 
Bell." 

Gibson  was  what  his  Yankee  friends  would  call  a 
handy  ,man.  As  a  lad  he  was  a  clever  mechanic.  When 
seventeen  he  built  a  small  house  for  amusement,  together 
with  a  boat  and  other  things.  All  craftsmen  loved  him. 
In  London  he  took  to  painting,  and  at  Sir  Charles  Bell's 
studied  under  Robert  Haydon,  the  eccentric,  enthusiastic 
artist  who  was  then  busied  on  Bell's  great  work  on  the 
hand. 

Gibson  was  fond  of  music,  too, — the  art  which  has 
always  so  attracted  men  of  his  profession, — and  while 
in  London  he  became  an  expert  violinist.  And  he  loved 
life  in  the  open  air.  He  was  given  to  long  country 
walks;  to  fishing  and  botanizing.  He  was  a  distin- 
guished ornithologist  and  an  expert  boxer.  While  a 
young  fellow  in  America  he  was  taught  to  spar  by  the 
famous  pugilist,  Jackson,  and  in  London  he  took  lessons 
of  the  no  less  renowned  Tom  Belcher.  So  he  enjoyed 
splendid  health,  and  with  that  to  bank  upon  he  got  more 
out  of  life  than  do  most  men. 


346  MEDICINE    IN    AMERICA. 

With  all  these  distractions  he  was  a  brilliant  and  at- 
tractive student.  Astley  Cooper  loved  him,  in  spite  of 
Bell,  and  foretold  great  things  of  him.  He  took  him 
with  him  in  his  journeyings  about  England,  so  that  Gib- 
son came  to  know  well  a  great  many  of  the  famous  per- 
sons of  the  time ;  and  the  young  man  used  to  relate  with 
pride  how,  as  a  rare  privilege,  he  once  went  with  Cooper 
to  see  an  operation  for  strangulated  hernia  in  the  case  of 
a  very  distinguished  personage. 

Those  were  the  days  of  the  Peninsular  War,  and  though 
the  relations  of  America  with  Great  Britain  were  be- 
coming daily  more  and  more  strained,  Gibson  entered 
with  the  greatest  enthusiasm  into  the  war  spirit  of  Eng- 
land in  her  struggle  with  France.  He  could  hardly  vol- 
unteer in  such  a  service,  but  his  curiosity  and  ardor  would 
not  be  denied  a  sight  of  what  was  doing.  So  in  De- 
cember, 1808,  with  some  friends,  he  chartered  a  trans- 
port and  sailed  for  the  scene  of  the  fighting.  Shortly 
before  this  the  British  forces  had  landed  in  Portugal  and 
driven  the  French  under  Junot  beyond  the  Ebro.  Napo- 
leon himself  had  come  to  the  relief  of  his  distressed  gen- 
eral, and  with  Soult  forced  the  campaign  which  ended  in 
the  battle  of  Corunna,  in  Januar)^,  1809,  and  the  evacu- 
ation of  Spain  by  the  English. 

Gibson  was  there  at  the  finish.  He  brought  his  trans- 
port up  to  that  northwestern  lands-end  of  Spain  and  saw 
the  discomfiture  of  the  English.  It  was  there  that  Sir 
John  Moore,  his  friend,  was  killed ;  and  it  was  in  mem- 
ory of  that  event  that  Charles  Wolfe  wrote  the  familiar 
lines, — 

"  Not  a  drum  was  heard,  not  a  funeral  note, 
As  his  corse  to  the  rampart  we  hurried." 

For  the  time  being  that  was  the  end  of  Gibson's  expe- 
rience of  European  war,  though  six  years  later,  when  for 
the  last  time  the  English  and  French  met,  at  Waterloo, 


XIX.  CENTURY.     GIBSON.  347 

he  happened  to  be  travelling  in  the  neighborhood,  took 
part  in  the  engagement,  saw  a  deal  of  hard  fighting,  and 
received  a  slight  wound.  Indeed,  he  was  a  ubiquitous 
person,  and  was  in  the  midst  of  most  of  the  disturbances 
which  were  exercising  men  in  the  days  of  his  youth.  At 
that  earlier  time  (1809),  however,  Corunna  satisfied  him. 
He  went  back  to  London,  stayed  his  year  out,  and  in 
18 10  sailed  for  America. 

Then  there  began  for  him  an  active  surgical  life  of 
incessant  endeavor.  He  had  scarcely  settled  himself  at 
his  old  home  in  Baltimore  when  he  became  interested  in 
establishing  a  medical  department  for  the  University  of 
Maryland,  and  in  181 1,  together  with  sundry  other  spirits 
of  kindred  ambition,  he  succeeded  in  successfully  launch- 
ing the  new  School,  himself  in  the  chair  of  Surgery.  Be 
it  remembered  that  at  this  time  he  was  only  twenty-three 
years  old. 

The  School  throve  apace,  and  Gibson  seems  tO'  have 
been  the  great  attraction  there.  He  was  a  brilliant  teacher 
and  a  bold,  original  operator.  Of  his  teaching,  espe- 
cially in  his  later  years,  a  great  deal  that  is  pleasant  has 
been  said  and  written.  In  an  introductory  lecture,  long 
afterwards,  he  described  his  purposes,  methods,  and 
ambitions :  "  One  thing  above  all  others  I  pride  myself 
upon;  I  have  never,  under  any  circumstances,  failed  to 
report,  faithfully  and  honestly,  the  result  of  my  practice 
and  operations,  whether  favorable  or  unfavorable.  I 
have  never  stated  any  important  or  marvellous  case  to 
the  class  without  giving  them  proofs  of  the  correctness 
of  my  statement,  either  referring  to  persons  associated 
with  me  or  to  other  circumstances  calculated  to  fortify 
my  own  report." 

Such  words  sound  commonplace  and  superfluous  now, 
but  they  were  not  so  in  those  old  times.  And  Gibson 
did  the  very  things  of  which  he  tells.  He  did  report  his 
failures  and  he  did  show  the  proofs  of  his  triumphs. 


348  MEDICINE   IN   AMERICA. 

The  then  world  of  doubtful  science  wondered  and 
shrugged  and  fell  feebly  into  line.  His  doings  were  of  a 
piece  with  his  early  prediction,  that  he  would  soon  fill 
Physick's  chair.  Writers  have  compared  his  bold  prin- 
ciples with  Physick's  practice.  Who,  it  was  asked,  ever 
heard  the  announcement  of  Physick's  failures?  Yet, 
being  mortal,  he  must  sometimes  have  failed.  At  any 
rate,  here  was  a  clean,  fresh  breeze  blowing  aside  the 
clouds  and  troubling  the  dust-heaps  of  spectacled  con- 
servatism and  bewigged  tradition. 

As  Gibson  grew  in  experience  he  acquired  a  vast 
knowledge,  which  was  always  at  the  command  of  his  audi- 
ences. He  developed  early  a  direct,  homely,  convincing, 
almost  familiar  style  of  lecturing;  and  his  intimacy  with 
the  fine  arts,  literature,  histor}^  politics,  and  men  gave 
him  a  storehouse  of  anecdote  and  illustration  which  he 
knew  well  how  to  use  to  captivate  hearers.  One  of  his 
old  pupils  said  of  him  that  he  spoke  straightforward  and 
to  the  point,  like  a  race-horse  well  trained.  His  words 
flowed  readily  and  clearly, — anecdotes,  cases,  descrip- 
tions, quotations, — without  hesitation  or  repetition.  He 
was  forever  giving  the  young  men  good  advice  and  mor- 
alizing upon  life  as  he  found  it.  He  urged  thoroughness 
and  care,  but  he  did  not  disguise  the  fact  that  these  alone 
do  not  always  bring  professional  success.  His  opinion 
of  humbugs  was  not  concealed.  Once,  in  a  burst  of  in- 
dignation, he  said,  "  Yet,  men  will  get  along  more  by  tact 
than  by  talent.  I  have  known  doctors  pretend  to  cry  with 
sympathy  at  the  bedside  and  win  the  doting  regard  of 
silly  women." 

In  those  early  days  of  teaching  and  practising  it  fell 
to  Gibson's  lot  to  do  an  operation  which  made  him 
famous.  In  1812,  the  year  after  the  founding  of  the 
Maryland  School,  he  tied  for  aneurism  the  common  iliac 
artery, — an  operation  never  before  performed  upon  the 
living.     It  was  a  proceeding  almost  as  bold  and  original 


XIX.  CENTURY.     GIBSON.  349 

as  Astley  Cooper's  ligature  of  the  aorta,  done  five  years 
later,  but  was  also  unsuccessful. 

In  those  years,  too,  we  were  again  at  war  with  Great 
Britain,  and  Gibson  had  a  chance  to  look  at  his  old 
friends  from  the  other  side  of  the  line.  In  1814  he  oper- 
ated on  Winfield  Scott  after  Lundy's  Lane  and  extracted 
a  bullet.  He  saw  the  battle  of  Bladensburg  and  the 
repulse  of  the  British  at  Baltimore,  and  from  all  these 
affairs  he  found  abundant  material  for  his  surgical  skill. 
The  iliac  operation  case  brought  him  before  his  world, 
and  now,  with  the  exception  of  Physick,  he  became  the 
best-known  and  most  popular  surgeon  south  of  New 
York. 

There  was  always  much  of  the  boy  in  him.  Business 
in  Baltimore  did  not  keep  him  from  many  hours  of  play, 
and  his  most  constant  playmate  was  a  young  lawyer  who 
shall  be  nameless.  The  two  used  often  to  go  fishing  and 
duck-shooting  together,  and  the  following  anecdote  is 
told  of  one  of  these  excursions. 

They  were  shooting  from  their  boat  one  day  in  the 
neighborhood  of  a  surly  fellow  who  was  fishing.  The 
fisherman  became  abusive  at  length  and  ordered  them  off 
his  grounds.  Thereupon  the  peppery  Gibson  jumped  into 
the  man's  boat  and  gave  him  a  sound  drubbing.  This 
disturbed  the  other  so  much  that  he  brought  a  suit  for 
assault,  and  Gibson  called  upon  his  legal  comrade  to 
defend  him.  The  defence  was  successful  and  the  fisher- 
man had  his  trouble  for  his  pains,  but,  to  the  chagrin 
of  the  athletic  surgeon,  his  lawyer  sent  him  a  heavy  bill 
of  charges.  Gibson  managed  to  control  himself  and  gave 
his  overreaching  counsel  no  hint  of  his  irritation.  Not 
long  after  the  two  went  shooting  again,  and  at  lunch  time 
sat  down  together  amicably  to  share  their  rations.  Un- 
seen by  his  companion,  Gibson  managed  to  mix  with 
the  former's  food  a  large  dose  of  tartar  emetic,  with  the 
result  that  the  attorney  promptly  became  frightfully  sick. 


350  MEDICINE    IN   AMERICA. 

The  doctor  rushed  to  his  assistance,  had  him  carried  to  a 
farm-house,  attended  him  through  an  illness  which  he 
took  no  special  pains  to  abridge,  and  when  the  patient 
was  well  enough  to  go  about  his  business,  sent  him  in 
for  professional  services  a  bill  which  balanced  the  fee  in 
the  assault  case. 

Practical  jokes  were  the  order  of  the  da}'-  in  those 
boisterous  times,  and  no  one  seems  to  have  thought  any- 
thing of  the  matter  except  that  the  lawyer  got  his  deserts. 

Such  were  some  of  the  accomplishments  and  pastimes 
of  the  man  in  his  younger  days,  and  much  such  a  man 
he  continued  through  life.  For  eight  years  he  held  the 
chair  of  Surgery  in  Baltimore,  and  had  established  so 
sound  and  brilliant  a  reputation  as  a  teacher  that  in  1819, 
after  the  retirement  of  Physick,  he  was  translated  to  the 
same  professorship  in  the  University  of  Pennsylvania. 
It  was  only  fourteen  years  since  he  had  made  his  youth- 
ful boast,  and  at  the  age  of  thirty-one  he  was  holding 
the  most  important  position  (from  a  surgical  stand- 
point) in  the  country. 

During  his  years  in  Baltimore  he  had  continued  to 
study.  In  181 5  he  made  a  second  trip  to  Europe,  this 
time  spending  some  months  in  France,  seeing  Napoleon 
during  the  Hundred  Days,  and  following  the  armies  to 
Waterloo.  Even  in  those  busy  times  he  made  many 
friends.  Napoleon  is  said  to  have  taken  a  fancy  to  him, 
just  as,  later,  such  eminent  Frenchmen  as  Velpeau, 
Ricord,  and  Victor  Hugo  numbered  him  among  their  ac- 
quaintances;  and  on  the  other  side  of  the  Channel  he 
counted  among  his  associates  and  correspondents  Byron, 
Tom  Moore,  Dugald  Stewart.  Brodie,  Jeffrey,  Aber- 
nethy.  Bell,  and  a  dozen  other  such.  Like  Coleridge,  he 
was  a  great  talker,  but  a  more  agreeable  person. 

While  in  Baltimore,  too, — indeed,  before  the  founding 
of  the  Maryland  School, — he  married  Sarah  Charlotte 
Hollingsworth,  and  became  in  time  the  father  of  three 


XIX.  CENTURY.     GIBSON.  351 

sons  and  two  daughters.  Later  in  life  he  married  a 
second  wife,  by  whom  he  had  three  children ;  and,  adds 
the  careful  recorder,  he  was  five  feet  seven  inches  tall, 
broad,  and  round-shouldered. 

In  Philadelphia — with  which  town  his  name  is  most 
commonly  connected — Gibson  had  a  long  and  honorable 
career.  For  nearly  thirty  years  he  divided  the  surgical 
honors  with  George  McClellan,'^  his  distinguished  con- 
temporary; and  it  was  not  until  1855  that  the  infirmities 
of  advancing  age  compelled  him  to  retire  from  teaching 
and  from  the  Philadelphia  Hospital,  where  he  had  long 
been  the  senior  surgeon. 

During  those  active  years  Gibson  produced  some 
writing  of  distinction.  His  best-known  publication  prob- 
ably was  his  "  Institutes  and  Practice  of  Surgery,"  which 
for  eight  editions  was  a  deservedly  popular  text-book. 
But  there  were  other  publications  of  his  which  are  better 
worth  reading  to-day.  Such  were  his  "  Sketches  of 
Prominent  Surgeons"  and  "  Rambles  in  Europe,"  his 
essay  on  "  Eminent  Belgian  Physicians  and  Surgeons," 
and  his  numerous  introductory  and  valedictory  addresses 
before  the  students  of  the  University. 

It  seems  as  though  most  of  the  prominent  doctors  of 
that  generation  had  some  hobby  which  they  overrode. 
Rush  and  J.  C.  Warren  tilted  against  windmills.  So, 
too,  Gibson  took  up  his  lance  and  led  a  crusade  against 
tobacco.  He  became  vice-president  of  an  anti-tobacco 
society,  himself  eschewed  the  weed,  and,  in  season  and 
out,  preached  that  it  destroyed  the  nervous  system  and 
led  to  blindness.  In  other  respects,  however,  he  liked  the 
pleasant  ways  of  life.  Good  things  to  eat  and  drink  were 
not  abhorrent  to  him,  and  his  wonderful  faculty  for  after- 
dinner  stories  was  famous  through  three  generations. 


*  George  McClellan   (1796-1847)  was  the  founder  of  the  Jefferson 
School  and  its  first  Professor  of  Surgery. 


152 


MEDICINE    IN    AMERICA. 


But  the  thing  which  most  impressed  his  professional 
brethren  was  his  astonishing  frankness.  They  tell  with 
admiration  how  he  published  in  full  his  unsuccessful  at- 
tempts to  reduce  by  force  old  dislocations  of  the  shoulder, 
and  how  in  four  cases  he  ruptured  axillary  arteries  and 
the  patients  died.  However,  not  all  his  striking  surgical 
endeavors  were  failures.  He  lost  the  case  of  ligature  of 
the  common  iliac;  but,  on  the  other  hand,  he  had  the 
unique  experience  of  doing  Caesarian  section  twice  on  the 
same  woman,  with  the  result  that  the  lives  of  the  mother 
and  both  children  were  saved. 

Of  his  remarkable  memory,  equal  almost  to  Macaulay's, 
there  are  many  anecdotes.  One  admirer  relates  how  he 
made  an  off-hand  bet  that  he  could  quote  three  hundred 
lines  of  Virgil  taken  at  random ;  when,  beginning  with 
the  second  book  of  the  ^neid,  he  reeled  off  the  hexam- 
eters until  his  dizzy  audience  begged  him  to  stop  and 
the  bet  was  paid. 

He  must,  indeed,  have  been  a  pleasant,  stimulating  per- 
sonage. Those  days  in  Philadelphia  were  the  ones  in 
which  Englishmen  were  getting  their  impressions  of 
American  life  from  Captain  Hall's  "  Travels  in  North 
America"  and  Dickens's  "American  Notes;"  and,  look- 
ing at  the  contrasted  pictures,  one  wonders  at  the  state 
of  the  camera  which  could  produce  such  varied  negatives. 

Gibson  withdrew  from  the  University  at  the  age  of 
sixty-seven.  He  had  filled  the  professor's  chair  thirty- 
six  years,  and  for  thirteen  years  longer — a  keen,  bright- 
eyed  old  man — he  watched  the  busy  world. 

It  was  a  very  tumultuous  time  for  retired  old  age. 
The  Civil  War  was  in  progress,  and  through  much  of 
it  Gibson's  native  Maryland  was  sadly  distraught.  Aside 
from  all  that,  the  Nestor's  usual  habits  were  grievously 
interrupted.  He  was  wont  to  say  that,  of  all  climates, 
Newport  was  the  most  delightful  in  summer  and  Florida 
in  winter.     However,  he  saw  the  end  of  the  War  of  the 


XIX.  CENTURY.    JACKSON.  353 

Rebellion,  and  resumed  his  travels  when  it  was  over. 
He  remained  so  occupied  until  his  death,  which  occurred 
in  Savannah  in  the  winter  of  1868.  If  now  he  is  in  large 
measure  forgotten,  he  seems  to  deserve  a  better  fate. 

James  Jackson,  of  Boston,  was  for  more  than  half  a 
century  the  "  beloved  physician."  He  was  a  man  of  ac- 
tion and  of  brains,  and  he  did  not  go  through  life  alto- 
gether without  conflicts ;  but  it  is  as  a  healer  of  the  sick 
that  he  will  longest  be  remembered  and  most  often 
quoted.  Certainly  it  is  a  unique  distinction.  I  know  of 
no  other  American  who,  had  he  done  nothing  else,  has 
left  behind  him  so  wide  and  sound  a  reputation  as  a 
practitioner  of  medicine.  Not  content  with  doing  such 
work  excellently  well,  he  wrote  a  book  about  how  to  do 
it :  a  charming  book,  still  to  be  read.  He  wrote  it  when 
he  was  an  old  man,  inscribing  it  to  his  life-long  friend, 
John  C.  Warren,  and  he  called  it  "  Letters  to  a  Young 
Physician  just  entering  upon  Practice."  In  order  to  ap- 
preciate these  letters,  read  first  Oliver  Wendell  Holmes's 
review  of  them.^ 

For  more  than  fifty  years  the  names  Jackson  and 
Warren  had  been  closely  associated  and  conspicuous  in 
Boston.  The  two  had  been  youths  and  college-mates 
together;  together  they  had  advanced  through  life: 
never  rivals,  always  close  friends,  emulous  only  for  the 
improvement  of  the  profession,  for  which  they  were 
keenly  jealous,  each  working  in  his  own  lines.  What 
Warren  became  as  a  surgeon,  we  have  seen.  Jackson 
was  the  accomplished  physician.  He  was  wise  after  the 
ancient  fashion,  and  in  these  days  of  "  the  new  medicine" 
that  fashion  is  not  to  be  despised.  It  was  mostly  a  study 
of  symptoms.  The  arts  of  auscultation  and  percussion 
were  becoming  known,  indeed ;    rough  chemical  analyses 


Boston  Medical  and  Surgical  Journal,  vol.  liii.  p.   197,  1855. 

23 


354  MEDICINE    IN    AMERICA. 

were  made,  and  those  things  which  appealed  to  the  un- 
aided senses  were  noted;  but  there  were  no  instruments 
of  precision  with  all  the  information  which  they  now 
bring  us. 

The  unaided  senses  seem  very  crude  things  to  us,  but 
it  was  amazing  to  what  refined  uses  in  diagnosis  the 
physicians  of  those  days  put  them.  Fever  was  estimated 
by  the  sense  of  touch,  the  gravity  of  the  condition  by 
the  sense  of  sight,  the  very  nature  of  the  ailment  by  the 
sense  of  smell,  and  the  senses  were  trained  to  an  acute- 
ness  of  perception  such  as  we  see  to-day  only  in  the  deli- 
cate fingers  of  the  blind  or  the  keen  nose  of  the  hound. 

Of  such  training  and  knowledge  Jackson  was  a  mas- 
ter, and  two  generations  of  physicians  had  been  reaping 
the  benefit  of  his  calm  judgment  and  penetrating  sagacity. 
Even  more  than  for  these  Holmes  prizes  the  long  friend- 
ship :  "  Pre-eminence  in  circles  that,  without  being  iden- 
tical, largely  intersected  each  other,  half  a  century  of 
professional  successes  within  the  same  narrow  precincts, 
selection  for  the  same  professional  honors;  and  out  of 
this  fiery  furnace,  fed  with  every  possibility  of  rivalry  and 
jealousy,  comes  this  golden  proof  of  unchanged  and  un- 
changeable affection,  fresh  as  when  the  morning  of  the 
century  set  the  stamp  of  heaven  upon  its  face.  Were 
there  nothing  in  these  pages  but  this  single  letter,  there 
would  be  more  to  think  of  and  to  speak  of  than  in  many 
a  volume  which  the  author  has  martyred  himself  to  spin 
out  and  the  reader  to  shorten." 

"  Why  '  doctors  differ'  so  often  may  well  be  asked, 
but  that  they  are  apt  to  do  so,  candor  itself  must  confess. 
Playwrights,  caricaturists,  and  farceurs  generally  agree 
on  this  point  and  they  cannot  all  be-wrong  about  it.  The 
reason  of  the  fact  is  plain  enough.  Lawyers  batter  each 
other  from  behind  their  legal  bastions  in  broad  daylight; 
clergymen  '  shell'  offending  brethren  from  their  mahog- 
any breastworks,  in  the  face  of  assembled  multitudes, 


XIX.  CENTURY.    JACKSON.  355 

with  loud  explosions.  But  the  doctor,  though  his  face 
belongs  to  the  street  as  much  as  the  signs  and  door- 
plates,  does  most  of  his  warfare,  as  well  as  his  acts  of 
mercy,  under  cover.  Hence  all  buzzing  scandals  find  a 
nidus  in  his  track,  and  creeping  hatreds  are  but  too  likely 
to  be  born  from  their  deposits.  .  .  .  Then  look  on  the 
fair  picture  of  these  two  illustrious  lives,  rising  in  the 
same  horizon,  shining  in  the  same  meridian,  declining 
to  the  same  sunset,  which  have  imparted  only  light 
and  warmth  to  each  other  in  the  long  path  they  have 
traversed !" 

Those  letters  of  Jackson  were  for  years  the  vade 
niecum  of  every  New  England  practitioner.  From  a  lit- 
erary stand-point  they  are  wholly  admirable,  as  a  collec- 
tion of  judicious  medical  maxims  they  are  almost  unique. 
The  scheme  is  as  follows :  A  wise  old  doctor  of  abundant 
experience  sits  down  with  a  young  beginner  and  talks  to 
him  about  practice.  There  is  no  pedantry,  no  quoting 
of  authorities,  no  labored  argument,  no  list  of  drugs. 
The  young  man  is  supposed  to  have  studied  his  books 
and  to  be  familiar  with  the  rules,  but  he  is  nervous  about 
his  own  acquirements  and  apprehensive  of  the  effect 
he  may  produce  on  his  first  patient.  The  genial  oracle 
takes  him  by  the  arm  and  tells  him  how  to  get  himself 
in  hand. 

The  first  letter  after  the  introduction  is  a  little  chat 
about  conduct  in  the  sick-room :  how  to  be  courteous 
and  not  bumptious,  how  to  be  impressive  and  not  pom- 
pous, how  to  hide  one's  own  misgivings  and  inspire  con- 
fidence, how  to  inspect  the  patient  without  staring,  how 
to  handle  him  without  mauling,  how  to  draw  conclu- 
sions and  prescribe  without  exciting  apprehension.  It 
is  probably  the  best  letter  of  the  collection,  and  ends  with 
this  confession :  "I  have  often  remarked  that  though  a 
physician  is  sometimes  blamed  very  unjustly,  it  is  quite 
as  common  for  him  to  get  more  credit  than  he  is  justly 


356  MEDICINE    IN    AMERICA. 

entitled  to;  so  that  he  has  not,  on  the  whole,  any  right 
to  complain." 

The  five  following  letters  deal  with  diseases  of  the 
nervous  system  and  are  full  of  useful  suggestions;  then 
come  two  on  dentition.  The  ninth  deals  with  cholera  in- 
fantum, the  next  three  with  various  infectious  diseases, 
including  pneumonia  and  phthisis,  and  ending  with  a 
pleasant  essay  on  dyspepsia.  The  remaining  six  treat 
of  gastro-intestinal  disorders,  calculi,  irritable  bladder, 
boils,  and  typhoid  fever. 

In  all  this  the  writer  does  not  pretend  to  give  the  full 
symptoms  of  the  diseases,  but  deals  with  them  in  a  chatty 
fashion,  pointing  out  familiar  difficulties,  sketching  com- 
plications, and  suggesting  remedies. 

It  is  a  little  book,  but  full  of  good  things,  and  makes 
one  wish  that  some  wise  man  to-day  would  write  a 
worthy  sequel.  Probably  that  bundle  of  letters  illustrates 
the  man — whom  many  of  us  remember — as  well  as  does 
anything  else  pertaining  to  him;  but  the  letters  were 
written  when  he  was  approaching  the  end  of  a  long  and 
saddened  career. 

James  Jackson  was  a  child  of  strenuous  Revolution- 
ary days,  and  was  born  on  October  3,  1777.  As  his 
grandson,  James  Jackson  Putnam,  has  written,  probably 
that  portion  of  his  life  included  between  the  years  1800 
and  1825  is  of  especial  interest, — "  when  medical  educa- 
tion in  New  England  received  its  great  impulse  through 
the  development  of  the  medical  school,  when  the  bonds 
of  medical  fellowship  were  cemented  by  the  reorganiza- 
tion of  the  Massachusetts  Medical  Society,  and  the  Mas- 
sachusetts General  Hospital  was  thrown  open  as  a  public 
charity." 

Jackson  was  a  native  of  Newburyport,  Massachusetts ; 
his  father,  Jonathan  Jackson,  and  his  mother  were  of  the 
best  old  New  England  stock,  the  father  conspicuous  as 
a  patriotic,  public-spirited  citizen.     The  son  James  was 


XIX.  CENTURY.    JACKSON.  357 

the  fifth  of  nine  children,  and  grew  up  with  his  brothers 
and  sisters  in  that  charming  Old- World  atmosphere  of 
good  breeding,  good  books,  self-restraint,  and  hard  work 
which  is  still  to  be  found  in  the  New  England  by-ways. 
Jackson  must  always  have  been  a  person  of  singular  at- 
traction :  gentle  but  courageous,  sensitive  but  strong  to 
endure,  sympathetic  but  helpful  and  uplifting.  Dignified 
he  was  withal,  and  gracious,  pure  of  heart,  and  single  of 
purpose.  Stanch  to  his  friends  and  charitable  to  all  the 
rest,  as  befitted  a  philosopher. 

His  education  was  of  the  kind  one  would  have  ex- 
pected :  at  first  in  the  schools  of  Newburyport,  later  in 
the  Latin  School  of  Boston,  to  which  place  his  father 
moved  in  1785.  Then  the  lad  went  to  Harvard  College, 
whence  he  was  graduated  in  1796. 

Like  his  friend  Warren,  Jackson  did  not  enter  upon  a 
medical  career  immediately  after  leaving  college.  He 
taught  school  at  the  Leicester  Academy  for  a  couple  of 
terms,  and  would  have  been  glad  to  pass  his  life  at  such 
work.  Late  in  that  same  year  (1796),  however,  his 
father  brought  him  to  Boston  to  be  a  clerk  in  his  own 
office  of  Supervisor  of  the  Internal  Revenue.  There  he 
worked  for  a  year,  and  then,  when  twenty  years  of  age, 
entered  the  office  of  the  veteran  Holyoke  in  Salem  and 
began  the  study  of  medicine.  Unlike  Warren,  he  em- 
barked upon  his  professional  studies  con  amove.  He  had 
felt  for  some  years  that  it  was  a  life  which  would  satisfy 
him, — either  that  or  teaching,  and  in  the  course  of  events 
he  saw  much  of  both.  Like  all  young  Harvard  men  of 
the  time,  he  had  also  been  given  a  taste  of  medical  studies 
in  College,  as  in  Cambridge  it  was  customary  for  the 
Senior  Class  to  attend  the  lectures  on  anatomy,  "  prac- 
tice," and  chemistry  given  by  the  little  faculty  of  which 
Warren's  father  was  chief. 

Jackson  spent  two  years  of  pupilage  with  Holyoke, 
during  which  time  he  won  the  affections  of  the  lady 


358  MEDICINE    IX    AMERICA. 

whom  he  afterwards  married.  She  was  EUzabeth  Cabot, 
eldest  daughter  of  George  Cabot,  the  distinguished  Fed- 
erahst.  ^Moreover,  the  two  years  were  made  memorable 
in  Jackson's  life  by  the  companionship  of  his  ''  glorious 
old  master,"'  Holyoke.  We  have  already  heard  some- 
thing of  that  venerable  man :  how  he  lived  to  a  great 
age  and  was  given  the  highest  honors  by  his  fellows. 
Jackson  always  esteemed  Holyoke  highly,  and  in  in- 
scribing to  him  his  thesis  on  the  Brunonian  System,  in 
1809,  he  says,  "  I  cannot  hesitate  a  moment  to  whom 
this  dedication  shall  be  made.  By  you  I  was  taught  to 
pay  a  sacred  regard  to  experience  as  -the  source  of  all 
medical  knowledge,  and  bv  vou  I  was  forbidden  to  resort 
to  speculative  principles  as  guides  to  practice  except 
where  experience  failed." 

That  inscription  gives  the  key-note  of  Holyoke's  teach- 
ing,— a  teaching  very  different  from  what  was  customary 
in  those  days.  As  Putnam  graphically  says,  *'  The  whole 
period  covered  by  the  joint  lives  of  Dr.  Holyoke  and  Dr. 
Jackson,  which  stretched  from  1728  to  1868,  or  nearly 
a  centur)'-  and  a  half,  witnessed  a  veritable  revolution 
in  medical  standards,  hopes,  and  aims;  the  transition 
from  a  condition  of  rank  superstition  to  one  of  splen- 
did achievement.  Of  this  great  transformation.  Dr. 
Holyoke  lived  long  enough  to  see  the  promise  and  Dr. 
Jackson  a  portion  of  the  fulfilment." 

In  October,  1799,  Jackson  left  his  old  master  and  his 
sweetheart  and  sailed  for  London  for  a  ten  months'  ab- 
sence. The  captain  of  the  vessel  was  his  own  brother 
Henry  and  the  ship  was  the  "  Thomas  Russell."  He 
spent  his  time  in  study  at  St.  Thomas's  Hospital,  where 
he  served  as  dresser,  besides  working  in  surgery  and 
anatomy  with  Cline  and  Astley  Cooper  at  Guy's.  He 
also  followed  the  new  practice  of  vaccination  at  the  St. 
Pancras  Hospital,  under  W'oodville,  and  took  regular 
courses  of  medical  lectures.     He  had  the  renewed  pleas- 


XIX.  CENTURY.    JACKSON.  359 

ure,  too,  of  finding  J.  C.  Warren  busied  with  the  same 
tasks.  All  this  work  brought  him  into  familiarity  with 
the  best  surgery  as  well  as  the  medicine  of  the  day;  but, 
in  spite  of  his  equipment  in  both  branches,  it  was  to  medi- 
cine that  he  devoted  himself  almost  exclusively  for  the 
greater  part  of  his  life.  The  medical  teaching  of  the 
united  hospitals  was  done  by  two  eminent  men,  both  of 
Guy's,  William  Saunders  and  William  Babington.  Jack- 
son spent  no  time  in  travel  or  in  visiting  other  medical 
centres.  Late  in  the  summer  of  1800  he  sailed  for  home, 
and  on  October  i,  two  days  after  reaching  Boston,  he 
began  practice. 

He  brought  with  him  from  England  a  new  therapeutic 
agent, — vaccine  virus, — the  use  of  which  made  him  at 
once  conspicuous.  A  short  time  previously  Waterhouse 
had  demonstrated  the  value  of  vaccination  by  employing 
it  in  the  case  of  his  own  son  and  afterwards  inoculating 
him  with  smallpox,  without  establishing  a  smallpox  in- 
fection. Jackson  instituted  the  practice  at  once,  and 
though  other  doctors  promptly  took  it  up,  the  prestige  of 
its  first  employment  remained  with  the  veteran  teacher 
and  the  young  beginner.  In  that  connection  he  notes  of 
himself  this  interesting  memorandum :  "  On  that  ques- 
tion, in  October,  I  derived  one  hundred  and  fifty  dollars 
from  that  source  and  also  just  as  much  from  other  busi- 
ness ;  that  made  my  fees  amount  to  three  hundred  dollars 
the  first  month.  In  the  remaining  eleven  months  of  my 
first  year  I  earned  five  hundred  dollars,  or  nearly  fifty 
dollars  a  month,  or  eight  hundred  dollars  for  the  first 
year." 

It  was  a  good  start,  fairly  and  honorably  made,  and 
the  young  man  very  properly  took  advantage  of  it.  From 
the  outset  vaccination  brought  him  into  prominence,  so 
that  he  had  the  unique  experience  of  going  through  a 
long  professional  life  without  a  day's  obscurity.  At  the 
end  of  that  first  year,  too,  he  took  to  himself  the  lady 


36o  MEDICINE    IN    AMERICA. 

who  had  promised  four  years  before  to  be  his  wife,  and 
so  cheerfully  assumed  the  burden  of  married  life. 

The  year  1801  is  also  memorable  in  Boston  medicine 
by  reason  of  the  return  of  J.  C.  Warren  from  Europe. 
He  came,  an  accomplished  surgeon.  Jackson  immediately 
recognized  the  fact  and  abandoned  to  his  friend  the  sur- 
gical field.  With  such  prospects  the  two  young  men 
plunged  into  their  life  work  and  were  immediately  con- 
spicuous. In  1803  their  first  important  pubhc  act  to- 
gether was  the  furthering  a  reorganization  of  the  Mas- 
sachusetts Medical  Society.  The  year  previous  Jackson 
had  received  the  degree  of  Bachelor  of  Physic  from  Har- 
vard College,  but  it  was  not  until  seven  years  later  ( 1809) 
that  the  degree  of  M.D.  was  conferred  upon  him.  His 
admirable  and  scholarly  thesis  on  the  latter  occasion  was 
an  arraignment  of  the  Brunonian  System,  which  was  soon 
to  go  the  way  of  all  theories  of  medicine. 

Throughout  those  years  the  old  subject  of  medical  edu- 
cation was  continually  recurring  to  him,  as  it  has  always 
recurred  in  the  lives  of  physicians  who  have  attained  real 
eminence.  Jackson  was  struggling  with  the  matter,  so 
was  Warren,  and  so  was  Warren's  father.  It  had  long 
been  evident  that  a  medical  school  in  Cambridge  could 
never  be  great.  The  place  was  too  inaccessible  and  too 
far  from  hospitals,  existing  or  projected.  In  the  begin- 
ning the  School  established  by  the  College  had  been 
located  within  the  College  grounds.  If  that  had  not 
existed,  however,  it  is  certain  that  long  before  18 10  some 
medical  school  would  have  been  established  in  Boston. 
Waterhouse  was  the  stumbling-block  to  making  the 
change,  for  he  lived  in  Cambridge  and  was  satisfied  with 
the  old  order;  but  in  spite  of  opposition,  the  removal 
was  at  last  made,  and  in  18 10  temporary  quarters 
were  found  at  49  Marlborough,  now  400  Washington 
Street,  where  instruction  was  given  for  three  years.  The 
two  Warrens,   Waterhouse,   Dexter,   and   Gorham   con- 


XIX.  CENTURY.     JACKSON.  361 

tinuedto  teach,  and  Jackson  was  made  Professor  of  Clini- 
cal Medicine,  so  as  not  to  displace  Waterhouse.  In  181 2, 
at  the  age  of  thirty-five,  he  became  Hersey  Professor  of 
Theory  and  Practice,  and  held  the  chair  until  1836.  For 
several  years,  until  the  opening  of  the  Massachusetts 
General  Hospital,  the  Boston  Almshouse  on  Leverett 
Street  was  utilized  for  clinical  teaching. 

The  Massachusetts  General  Hospital  was  also  an  object 
of  Jackson's  earnest  and  useful  endeavors.  Equally  with 
J.  C.  Warren,  he  was  one  of  its  founders,  and  it  had  a  very 
important  bearing  on  his  career.  That  hospital  work,  the 
upbuilding  of  the  School,  and  the  reorganizing  of  the 
Medical  Society  were  his  three  great  public  contributions 
to  American  medicine, — each  of  them  a  notable  work  had 
he  done  nothing  else. 

He  was  a  conspicuous  and  popular  teacher,  though  not 
brilliant;  but  he  gained  and  held  the  confidence  of  his 
pupils.  What  he  told  them  was  sound,  they  came  back  to 
him  for  advice,  and  until  his  old  age  he  continued  to  gain 
upon  their  affectionate  regard  as  he  did  upon  that  of  his 
countless  patients.  He  moved  in  a  class  by  himself.  The 
striking  thing  is  that  the  position  he  filled  in  18 12 — in 
the  days  of  our  grandfathers — was  still  retained  by  him 
within  the  memory  of  very  many  of  us  who  are  now  prac- 
tising medicine. 

Of  those  forty  years  after  the  establishment  of  the  Hos- 
pital there  is  little  to  be  said.  Jackson's  life  was  marked 
with  the  usual  sunshine  and  storm  which  become  the  lot 
of  most  of  us.  He  was  busy  and  successful,  and  experi- 
enced no  great  crises  save  one, — the  loss  of  his  favorite 
son.  That  blow,  however,  was  so  grievous  that  it  marked 
the  man  ever  after;  sorely  wounded,  but  not  broken- 
hearted, he  survived  his  son  thirty-five  years.  One  corner 
of  our  little  world  was  the  richer  for  his  sorrow,  for  it  led 
him  to  the  production  of  a  Memoir  which  has  become  a 
classic  among  American  medical  writings.     In  truth,  as 


362  MEDICINE    IN    AMERICA. 

time  passes,  I  am  inclined  to  think  that  we  are  coming 
more  and  more  to  appreciate  and  benefit  by  that  book. 
Of  all  his  writings,  not  excepting  the  "  Letters,"  it  is  the 
one  most  likely  to  find  a  permanent  place  in  our  literature. 
Ten  years  ago  I  read  it  first,  and  I  have  been  reading  it 
this  very  week  with  increasing  pleasure. 

In  the  narrative — and  its  title  is  simply  "  A  Memoir  of 
James  Jackson,  Jr.,  M.D." — the  writer  tells  briefly  the 
stimulating  story  of  the  young  man's  life,  weaving  into 
it  the  reflection  of  his  own  hopes,  fears,  and  ambitions  for 
the  lad.  He  shows  us  a  pure,  gifted,  and  highly  trained 
character ;  he  follows  him  through  his  professional  studies 
in  this  country  and  in  Europe;  he  illustrates  it  all  by 
quoting  freely  from  their  mutual  letter  files ;  and  he  leaves 
us  a  remarkable  picture  of  the  courage,  high  purpose, 
ability,  and  rare  usefulness  of  both  father  and  son.  In- 
deed, the  hearts  of  the  two  men  were  so  united  in  life  that 
the  death  of  the  younger  served  only  to  inspire  the  father 
to  carry  on  the  work  of  both.  Already  eminent  himself, 
the  elder  Jackson  seems  to  have  thrown  himself  into  his 
son's  generation  after  the  latter's  death,  and  eagerly  to 
have  preached  the  new  learning  with  which  the  young 
man  had  come  laden  from  Europe.  Gerhard,  who  was 
an  intimate  friend  of  the  younger  Jackson  in  Paris,  wrote 
home,  "  He  has  superior  talents,  and  his  excellent  educa- 
tion, conducted  by  his  father,  unquestionably  the  first  phy- 
sician in  America,  has  cultivated  his  mind  and  developed 
an  ardent  attachment  to  medicine." 

The  Memoir  is  altogether  charming  and  convincing. 
The  father's  partiality  is  rarely  apparent;  the  work  and 
writings  of  the  young  man  speak  for  themselves.  In 
truth,  the  father  wins  us  at  once  by  the  gracious,  noble 
dignity  of  his  introduction.  "  Who  will  believe  that  I 
shall  ])e  impartial  ?  I  can  say,  however,  that  I  would  not 
willingly  be  guilty  6f  exaggeration,  if  it  were  only  from 
the  love  of  truth  which  formed  the  most  distinguishing 


XIX.  CENTURY.    JACKSON.  363 

trait  in  his  character.  .  .  .  He  loved  me  as  few  sons  love 
their  fathers.  But  he  loved  truth  better,  and  would  not 
subscribe  to  any  opinion  because  it  was  mine,  though 
he  was  quite  willing  to  submit  to  my  direction  and 
control." 

The  young  man's  life  was  a  simple  one.  With  the 
single  exception  of  Elihu  Smith,  I  know  of  no  man  in 
the  profession  of  medicine  in  America  whose  short 
career  was  so  rich  in  results  and  who  left  behind  so 
touching  a  story. 

He  was  born  on  January  15,  1810,  the  second  son  of  his 
parents.  In  1828  he  was  graduated  from  Harvard  College 
and  immediately  took  up  the  study  of  medicine  under  his 
father's  guidance,  attending  at  the  same  time  the  lectures 
and  demonstrations  at  the  Medical  School  and  Hospital. 
It  was  a  bright,  generous,  enthusiastic  young  life;  free 
from  guile,  but  strikingly  intelligent  and  with  eyes  wide 
open  to  the  good  and  evil  in  the  world.  Not  a  youth  to 
cause  anxiety  to  his  noble-hearted  father,  though  the  lat- 
ter admits  a  few  qualms  when  he  saw  him  sail  gayly  away 
to  encounter  the  fascinations  of  London  and  Paris.  But 
the  qualms  were  needless,  for  the  son  had  learned  thor- 
oughly the  gospel  of  work.  During  the  last  three  years 
at  home  his  industry  had  been  prodigious  and  his  conse- 
quent acquirements  remarkable.  In  Europe,  and  in  Paris 
especially,  it  was  the  same  story.  The  example  of  Louis 
there  and  the  intimate  friendship  of  Gerhard  and  Pen- 
nock  were  not  likely  to  change  his  habits. 

It  was  the  life  in  Paris  and  the  almost  paternal  affec- 
tion of  Louis  for  the  young  man  that  have  made  his  pro- 
fessional studies  noteworthy.  While  in  that  city  he  de- 
voted his  time  mostly  to  three  hospitals, — La  Pitie,  St. 
Louis,  and  des  Enfans  Malades;  but  it  was  to  the  first 
that  he  especially  attached  himself,  for  there  he  heard  the 
lectures  and  saw  the  work  of  Louis  and  Andral.  The 
routine  of  the  days  was  remarkable,  and  is  thus  described 


364  MEDICINE    IN    AMERICA. 

in  a  letter  of  Gerhard,"  who  followed  the  same  course: 
"  Dr.  Louis  is  delivering  an  interesting  clinic  at  La  Pitie ; 
he  is  a  remarkable  man,  very  different  from  the  physi- 
cians of  England  or  America,  and  remarkable  even  at 
Paris  by  the  strict  mathematical  accuracy  with  which  he 
arrives  at  his  results;  he  is  not  a  brilliant  man,  not  of 
the  same  grade  of  intellect  as  his  colleague  at  La  Pitie, 
Andral.  .  .  .  The  morning  from  seven  to  ten  is  occupied 
with  the  visit  and  clinic  at  the  Hospital ;  there  are  several 
distinct  clinics  now  in  actual  progress.  ...  At  this  mo- 
ment we  are  following  Piorry  at  the  Salpetriere.  From 
there  we  hurry  to  La  Pitie;  we  hear  a  surgical  lecture, 
reach  home  to  breakfast,  and  then  to  the  School  of  Medi- 
cine. The  lectures  at  the  School  with  a  private  course  of 
anatomy  during  the  hour  of  intermission  fill  up  the  re- 
mainder of  the  day  until  four.  .  .  .  We  dine  at  five- 
thirty  and  then  lectures  again  until  eight  o'clock." 

Then  there  is  this  in  another  letter;  it  concerns  Jack- 
son as  much  as  his  enthusiastic  friend :  "  I  must  write 
you  at  least  a  few  days  before  the  excitement  has  passed 
off;  can  you  imagine  how  fortunate  I  am — devinez  si 
voiis  poiwez — two  or  three  days  ago  Jackson,  Pennock, 
and  myself  were  talking  of  hospitals  and  morbid  anat- 
omy, when  the  idea  occurred  of  attempting  the  study  of 
pathology  in  a  particular  manner.  It  was  this :  to  obtain 
the  specimens  and  study  them,  the  authors  in  our  hand, 
exactly  and  carefully  comparing  authorities  with  the  sub- 
ject before  us.  We  addressed  ourselves  to  two  of  the 
internes  at  La  Pitie,  attached  to  the  salles  of  Louis  and 
Andral,  and  they  agreed  to  procure  all  facilities  in  their 
power  and  communicate  their  own  information  for  the 
compensation  of  sixty  francs  from  each  of  us.  .  .  .  Our 
first  success  in  this  opening  of  new  sources  of  instruc- 


"  William  Osier,  Influence  of  Louis  on  American  Medicine,  Johns 
Hopkins  Hospital  Bulletin,  vol.  viii.  p.   161,  1897. 


XIX.  CENTURY.    JACKSON.  365 

tion  emboldened  us  to  attempt  something  of  higher  im- 
portance. We  were  all  desirous  of  studying  ausculta- 
tion ;  of  studying  it  in  such  a  manner  as  to  be  sure  of  our 
ground  on  our  return  and  to  be  capable  of  appreciating 
the  advantages  of  the  art.  Louis's  public  instructions 
were  valuable,  but  his  private  lessons  upon  a  subject  de- 
manding minute  and  patient  inquiry  we  knew  would  be 
infinitely  more  so.  I  therefore,  in  the  name  of  my  friends, 
addressed  him  a  polite  note  accompanied  by  a  handsome 
pecuniary  offer;  we  did  this  with  little  hope  of  success, 
but  happily  for  us  he  accepted  our  proposition,  and  next 
week  we  are  his  private  pupils  at  La  Pitie. 

"  We  are,  I  believe,  the  first  who  have  made  this  ar- 
rangement with  M.  Louis.  Our  advantages  for  the  study 
of  pathology  and  the  diagnosis  of  diseases  of  the  chest 
are  now  superior;  they  are,  indeed,  the  very  best  in  the 
world." 

That  was  the  beginning  of  young  Jackson's  intimacy 
with  Louis, — an  intimacy  which  lasted  for  the  brief  re- 
mainder of  his  life,  and  ripened  shortly  into  a  fatherly 
solicitude  and  affection  on  the  one  side  and  a  rarely  re- 
freshing filial  love  and  admiration  on  the  other.  Louis 
quickly  perceived  that  he  had  at  his  hand  a  scientific  jewel 
of  price,  and  was  urgent  that  the  young  man  should  post- 
pone practice  for  four  years  and  follow  in  his  own  foot- 
steps as  an  investigator  and  recorder.  His  views,  as  ex- 
pressed in  letters  to  the  elder  Jackson,  are  well  worth 
reading. 

"  It  did  not  require  much  time  for  me  to  appreciate 
fully  the  sagacity  and  talent  which  your  son  possesses  in 
the  observation  of  nature.  .  .  .  Let  us  suppose  that  he 
should  pass  four  more  years  without  engaging  in  the 
practice  of  medicine,  what  a  mass  of  positive  knowledge 
will  he  have  acquired !  How  many  important  results  will 
he  have  been  able  to  publish  to  the  world  during  that 
period !     After  that  he  must  necessarily  become  one  of 


366  MEDICINE   IN   AMERICA. 

the  bright  hghts  of  his  countr}^;  others  will  resort  to  him 
for  instruction,  and  he  will  be  able  to  impart  it  with  dis- 
tingxiished  honor  to  himself." 

And  again,  "  My  only  wish  was  that  you  should  allow 
your  son  to  devote  himself  exclusively  to  observation,  for 
several  years,  in  Boston. 

"  Think  for  a  moment,  sir,  of  the  situation  in  which 
we  physicians  are  placed.  We  have  no  legislative  cham- 
bers to  enact  laws  for  us.  We  are  our  own  law-givers; 
or,  rather,  we  must  discover  the  laws  on  which  our  pro- 
fession rests.  We  must  discover  them  and  not  invent 
them ;  for  the  laws  of  nature  are  not  to  be  invented.  And 
who  is  to  discover  these  laws  ?  Who  should  be  a  diligent 
observer  of  nature  for  this  purpose,  if  not  the  son  of  a 
physician  who  has  himself  experienced  the  difficulties  of 
the  observation  of  disease,  who  knows  how  few  minds 
are  fitted  for  it,  and  how  few  have  at  once  the  talents  and 
inclination  requisite  for  the  task?" 

Of  such  sort  was  the  young  man,  and  it  seems  a  hard 
fate  which  cut  him  off  before  those  abilities  were  brought 
to  fruitage.  For  various  reasons  his  father  decided  to 
have  him  come  home  at  the  end  of  two  years,  and  the  son 
did  so,  with  the  purpose  of  entering  upon  practice.  But 
the  leaving  Louis  was  bitter  to  him.  He  seems  to  have 
felt  that  he  was  seeing  that  great  man  for  the  last  time, 
and  wrote  to  his  father,  "  I  will  not  attempt  to  describe 
to  you  the  agony  it  gives  me  to  quit  Louis.  He  is  my 
second  father,  and  God  knows  that  is  a  name  I,  of  all 
men,  cannot  use  lightly.  .  .  .  From  one  upon  whom  I 
had  no  claim,  but  those  which  my  life  and  mind  and 
habits  gave  me,  I  have  experienced  a  care,  an  affection 
which  I  never  could  have  expected  from  any  one  but  my 
dear  father  and  which  I  shall  ever  feel  to  be  the  most 
honorable  and  truly  worthy  prize  of  my  life." 

It  was  the  last  prize  of  his  life.  Late  in  1833  he  re- 
turned to  Boston.     Early  in  1834  Harvard  gave  him  the 


XIX.  CENTURY.    JACKSON.  367 

degree  of  M.D.,  and  on  March  2J  of  that  same  year  he 
died,  in  his  twenty-fifth  year. 

The  effect  on  the  father  was  overwhelming  for  the 
time,  but  he  was  not  crushed.  He  had  felt  that  his  son 
was  coming  home  to  be  to  him  another  right  hand,  an- 
other brain ;  to  tell  him  of  the  great  things  doing  in 
Europe,  to  teach  him  new  thoughts  and  new  methods,  to 
bring  fresh  enthusiasm,  accuracy  of  system,  and  exact 
knowledge  to  supplement  the  wide  experience  of  the  older 
man.  Here  was  an  end  of  all  such  dreams;  but,  rising 
from  the  blow,  Jackson  first  wrote  that  book  about  the 
lad, — a  book  teaching  the  inspiring  lesson  which  every 
student  of  medicine  should  know, — and  then  he  directed 
his  own  life  and  practice  to  advance  and  illustrate  the  new 
learning  which  had  come  to  him  in  those  last  years.  Like 
Bigelow,  his  pupil,  he  early  came  to  recognize  the  short- 
comings of  the  ancient  therapeutics,  and,  though  he  never 
arrived  at  that  pitch  of  "  therapeutic  nihilism"  which  dis- 
tinguished Bigelow,  he  saw  clearly  the  self-limited  nature 
of  disease  and  taught  and  acted  in  accordance  with  the 
new  light. 

He  was  first  and  last  a  frequent  writer  of  other  things 
besides  his  two  best-known  books.  Putnam  '^  gives  a  list 
of  sixteen  journal  articles  and  sixteen  more  extensive 
publications, — books  and  pamphlets.  Many  of  them  are 
still  useful;  all  are  interesting.  The  following  are  some 
of  Jackson's  honors  and  titles  : 

Harvard  A.B.,  A.M.;  M.B.  1802,  M.D.  1809,  LL.D. 
1854;  Hersey  Professor  of  the  Theory  and  Practice  of 
Physic ;  Professor  Emeritus ;  Overseer  of  Harvard ; 
President  of  the  American  Academy  of  Arts  and 
Sciences;    member  of  the  American   Philosophical   So- 


^  James  Jackson  Putnam,  Sketch  of  Dr.  James  Jackson  in  the  Har- 
vard Medical  Alumni  Quarterly  for  January,  1903. 


368  MEDICINE    IN   AMERICA. 

ciety;  honorary  member  of  the  Royal  Medico-Chirurgical 
Society,  London. 

So  through  another  generation,  after  1834,  his  hfe  and 
work  went  on, — a  Hfe  well  rounded,  except  for  the  one 
grievous  loss,  and  always  useful ;  to  be  remembered, 
among  other  things,  for  the  high  ideals,  scholarly  attain- 
ments, unflagging  industry,  and  great  love  of  his  kind 
which  always  distinguished  the  man. 

He  died  on  August  27,  1867. 


CHAPTER    XIII. 

THE    NINETEENTH    CENTURY.       DANIEL   DRAKE    AND    THE 
WESTERN    SCHOOLS. 

While  such  strong  characters  as  Rush,  Hosack,  and 
Bigelow  were  advancing  medicine  on  our  seaboard,  there 
was  hving  and  working  in  the  West  a  man  of  whom  we 
must  think  as  one  of  the  ablest,  and  perhaps  the  most  ver- 
satile, of  the  physicians  that  America  produced  in  the  first 
half  of  the  last  century :  Daniel  Drake,  a  fine  example  of 
that  splendid  Western  type  which  built  up  a  great  em- 
pire out  of  the  wilderness  in  the  course  of  less  than  fifty 
years. 

Hitherto,  our  experience  of  distinguished  American 
doctors  has  been  that  most  of  them  were  men  of  gentle 
birth  and  good  education,  trained  in  our  best  schools  and 
in  the  hospitals  of  the  Old  World,  even  the  pioneers  Mc- 
Dowell and  Dudley  having  enjoyed  that  last  advantage. 
For  Drake  there  were  none  of  these  things,  yet  he  was,  in 
middle  life,  a  man  of  broad  culture,  of  keen  sensibility, 
of  wide  reading;  a  scientific  writer  well  known  in  Eu- 
rope, a  famous  teacher,  and  carrying  with  him  always  an 
unflagging  enthusiasm  and  the  highest  of  ideals.  To 
many  of  us  to-day  little  more  than  a  name,  he  was  a  man 
who  profoundly  impressed  thousands  of  men  in  his  gen- 
eration, and  our  Middle  West  rightly  regarded  him  as  a 
great  American. 

Beginning  life  as  the  son  of  a  struggling  settler,  in  cir- 
cumstances little  different  from  those  which  surrounded 
his  famous  neighbor,  Abraham  Lincoln,  he  developed, 
while  still  a  young  man,  into  a  leading  citizen  and  the 
foremost  physician  of  the  West;  and  when  he  died,  at 
sixty-seven,  science  lost  one  of  her  strongest  men. 

24  369 


370  MEDICINE    IN   AMERICA. 

He  was  an  all-around  man,  with  abilities  fit  for  diverse 
pursuits.  He  might  have  been  a  prominent  lawyer, 
preacher,  statesman,  or  engineer.  Gross,  who  knew  him 
well,  says  that  he  would  have  made  a  great  Secretary 
of  State,  for  he  had  the  astuteness  of  a  Webster,  the 
subtlety  of  a  Calhoun,  and  the  indomitable  energy  of  a 
Benton. 

Most  happily  for  medicine,  however,  his  enthusiasm 
was  turned  towards  that  profession,  and  we  must  believe 
his  most  salient  characteristics  to  have  been  a  devotion  to 
his  calling  and  a  boundless  love  for  and  faith  in  the  West- 
ern country  in  which  he  always  chose  to  live. 

He  was  a  founder  of  medical  schools,  and  always 
wished  to  be  regarded  as  a  teacher.  He  was  called  to 
eleven  different  chairs  in  six  different  schools;  he  was 
an  eloquent  teacher,  an  able  medical  journalist,  a  wise  and 
far-seeing  promoter  of  great  public  enterprises,  a  hope- 
ful and  constant  reformer,  and  the  author  of  a  monu- 
mental work  on  the  "  Interior  Valley  of  North  Amer- 
ica,"— a  work  necessitating  immense  toil  and  research 
and  of  undoubted  accuracy  and  value. 

In  one  way  or  other  he  was  associated  with  very  many 
of  the  leading  physicians  and  public  men  throughout  the 
land,  and  the  story  of  his  life,  more  than  that  of  any 
other  doctor  of  his  generation,  with  the  possible  excep- 
tion of  the  elder  Bigelow,  shows  the  development  of 
our  medical  progress  in  the  first  half  of  the  nineteenth 
century. 

Three  years  ago,  at  a  meeting  of  the  Mason  County 
Medical  Society  in  Kentucky,  the  orator  of  the  occasion 
sketched  a  dreary  picture  of  the  early  pioneer  life,  and 
told  of  the  dull,  humble  hopelessness  of  the  struggling 
parents  of  Daniel  Drake,  —  down-trodden,  despairing, 
bowed  by  the  labor  of  centuries ;  then  he  told  how,  look- 
ing forward  with  simple  faith  for  the  future  of  their 
children,   if  not   for  their  own   present,   they  sacrificed 


XIX.  CENTURY.     DRAKE.  371 

themselves  to  make  of  Daniel  a  doctor  and  a  "  gentle- 
man." There  is  a  pretty  pathos  in  it  all,  but  it  hardly  fits 
in  with  what  we  know  of  that  rough,  sturdy,  hopeful 
West  a  hundred  years  ago,  and  Drake  himself  tells  the 
story  in  quite  another  spirit. 

First  and  last,  we  know  a  good  deal  about  him.  He 
wrote  "  Reminiscential  Letters"  to  his  children,  his  friend 
Edward  D.  Mansfield  published  a  readable  Life  of  him 
soon  after  his  death,  and  the  prolific  Gross  wrote  of  him 
much  that  is  pleasant  to  hear. 

Daniel  Drake  was  born  in  New  Jersey  on  October  20. 
1785,  and  so  was  of  the  same  age  as  Mott  and  Dudley. 
His  father,  Isaac,  was  the  son  of  a  farmer  and  miller 
who  lived  near  where  Plainfield  now  stands,  and  both  the 
father  and  grandfather  were  frequently  in  arms  for  the 
patriot  cause  during  the  Revolution.  In  1784  Isaac 
Drake  married  Elizabeth  Shotwell,  the  daughter  of  a 
Quaker  family,  and  Daniel  was  their  eldest  son.  In  1788, 
when  the  child  was  in  his  third  year,  Isaac  Drake  moved 
West  with  his  family  and,  after  months  of  adventure  in 
the  wild  country,  settled,  with  a  number  of  others,  on  a 
tract  of  land  in  Mason  County,  Kentucky.  The  place  was 
about  ten  miles  from  the  Ohio  River ;  they  called  it  May's 
Lick.  Those  were  pioneers  indeed.  Forests  covered  the 
State,  Indians  abounded,  men  travelled  fearfully,  on  the 
lookout  for  savages  and  wolves.  The  only  town  of  any 
importance  in  the  region  was  Lexington,  founded  about 
1776,  and  so  named  after  the  Massachusetts  village. 
Ohio,  to  the  north  of  them,  was  even  more  of  a  wilder- 
ness ;  for  the  first  settlement  of  that  State  had  Ijeen  made 
at  Marietta  only  sixty-four  days  before  our  emigrants 
landed  from  their  boat  on  the  Kentucky  shore. 

In  such  a  country,  and  in  wild  company,  young  Drake 
passed  his  boyhood.  He  describes  much  of  it  himself, 
and  tells  of  a  lawless,  free,  open-air  existence,  where  hu- 
man life  was  held  cheap,  where  every  man  was  a  law 


372  MEDICINE    IN    AMERICA. 

unto  himself,  and  where  whiskey  and  gunpowder  were 
the  commonplace  of  boys. 

From  his  childhood  Drake's  father  had  purposed  to 
make  a  doctor  of  him.  The  elder  man,  while  voyaging 
down  the  Ohio  River,  became  acquainted  with  Dr.  Wil- 
liam Goforth,  an  enterprising  physician,  well  named  for 
the  adventure  on  which  he  was  bent.  Goforth  was  edu- 
cated and  able;  he  appreciated  the  sturdy  courage  and 
faith  of  the  folk  among  whom  he  found  himself;  and, 
settling  near  them  in  the  village  of  Washington,  he  lived 
there  for  the  next  eleven  years,  their  sincere  friend  and 
well-wisher.  Isaac  Drake  admired  and  trusted  him,  and 
when,  in  1800,  Goforth  removed  to  the  rising  town  of 
Cincinnati,  across  the  Ohio,  Drake  sent  his  fifteen- 
year-old  son,  Daniel,  to  join  him  there  and  to  become  a 
doctor. 

We  are  wont  to  think  of  that  year  1800, — the  year 
after  Washington's  death,  —  when  our  young  country 
was  struggling  into  existence,  when  the  city  of  Wash- 
ington was  being  laid  out,  when  the  seaboard  was  begin- 
ning to  recover  from  the  storm  of  war,  when  politics  were 
running  rampant,  when  Hamilton  and  Adams  and  Gou- 
verneur  Morris  on  one  side  and  Jefferson  and  his  like  on 
the  other  were  grappling  in  a  battle  that  ended  in  the 
overthrow  of  the  Federal  party  and  the  firm  seating  of  a 
triumphant  democracy — we  are  wont  to  think  of  all  that 
as  very  long  ago;  and  to  feel  that  such  history  as  we 
then  had  was  confined  to  narrow  limits.  But  on  the 
banks  of  the  Ohio  a  new  nation  was  growing  up,  with  a 
new  civilization,  with  new  purposes,  and  with  new  ideals, 
and  here  our  wide-awake  lad  of  the  woods  began  the 
study  of  medicine  and  took  his  place  in  that  new  world. 
He  was  not  the  first  Western  student,  as  we  know ;  but 
those  others,  McDowell  and  Dudley,  were  better  born,  as 
birth  was  then  rated,  and  started  with  some  tincture  of 


XIX.  CENTURY.     DRAKE.  373 

those  humanities  which  Drake  was  to  acquire  painfully 
and  always  by  himself. 

Of  course  he  was  rough,  uncouth,  and  illiterate;  he 
could  read  and  write,  and  there  his  studies  ceased.  He 
had  intelligence,  steadfastness,  good  health,  and  ambi- 
tion, and  he  was  going  into  the  family  of  the  popular  phy- 
sician of  the  region.  Two  years  later  Dr.  John  Stiles 
came  out  from  New  York,  settled  in  the  place,  and  became 
the  partner  of  Gofortli.  Both  men  became  the  directors 
of  young  Drake. 

The  lad  saw  almost  at  once  that  he  was  an  ignoramus 
in  book-learning,  but  he  had  a  keen  and  kindly  tact  with 
folk,  and,  in  spite  of  disadvantages,  acquired  a  precocious 
knowledge  of  human  nature  and  an  understanding  of  the 
meaning  of  symptoms  which  made  him  of  great  use  to 
Goforth  before  his  four  years  of  apprenticeship  were 
over. 

Goforth  was  a  good  doctor  and  a  busy  man,  but  lacked 
business  sense  and  was  always  in  debt.  He  had  a  small 
medical  library,  which  was  at  Drake's  disposal,  and  de- 
cided notions  of  practice,  gleaned  from  Cullen  and  the 
eighteenth-century  masters.  So  Drake  set  to  work  read- 
ing Cullen  and  Haller,  Cheselden,  Boerhaave,  Van 
Swieten,  and  Chaptal.  With  the  advent  of  Stiles,  fresh 
from  the  Eastern  schools,  he  was  introduced  to  Rush,  and 
he  devoured  the  writings  of  that  American  master,  whom 
he  admired  profoundly  through  life.  Besides,  he  ran 
errands,  mixed  drugs,  and  kept  the  books  for  his  negli- 
gent, kindly  preceptor. 

What  seems  to  have  been  quite  as  important  a  part  of 
his  education,  he  became  associated  with  a  company  of 
superior  people  and  began  to  polish  his  manners  and 
broaden  his  horizon. 

In  those  early  days  of  national  expansion  democratic 
habits  were  much  more  common  than  they  have  since  be- 
come in  our  present  more  complex  civilization.     The  peo- 


374  MEDICINE    IN    AMERICA. 

pie,  rich  and  poor,  gentle  and  simple,  had  a  common 
birthright :  they  were  American  born  ;  there  was  no  great 
distance  between  the  highest  and  the  lowliest.  In  the  out- 
pouring westward  from  New  England  and  the  Atlantic 
States,  men  of  all  grades  mingled  freely  together  and, 
shoulder  to  shoulder,  carved  their  way  in  the  wilder- 
ness. Some  remnant  of  such  conditions  may  still  be  seen 
in  the  new  towns  of  our  far  West.  Men  of  education  and 
some  property  were  among  the  emigrants;  they  were 
taking  with  them  their  families  and  their  penates ;  they 
were  settling  towns  and  buying  farms ;  they  were  law- 
yers, doctors,  promoters,  as  well  as  farmers  and  adven- 
turers. While  the  country  was  being  cleared  and  the 
virgin  fields  were  yielding  their  first  crops,  these  men 
were  building  schools,  founding  colleges,  serving  in  legis- 
latures, organizing  societies  for  mutual  improvement,  and 
spreading  broadcast  the  seeds  of  the  best  culture  which 
they  had  known  in  the  East.  Then  there  followed  roads 
and  steamboats  and  canals,  and  railways  a  little  later.  It 
was  a  very  remarkable  company  of  pioneers,  always  build- 
ing and  establishing  and  developing  and  moving  forward ; 
leaving  behind  many  untilled  spaces,  as  we  still  see,  but 
always  progressive,  until  within  sixty  years  after  the 
close  of  the  Revolution  they  were  stopped  only  by  the 
Pacific  Ocean,  two  thousand  five  hundred  miles  from 
Yorktown. 

Cincinnati  was  one  of  the  halting-places  of  this  ad- 
vancing tide.  In  1800  it  was  a  small,  rude  town,  with 
an  army  post. — Fort  Washington ;  and  among  the  con- 
spicuous citizens  were  men  whose  names  are  known  to- 
day in  the  region :  Symmes,  Harrison.  Findley,  Gano, 
Stone,  Longworth,  Wallace,  Zeigler,  Stanley,  Hunt, 
Yeatman,  and  the  like.  There  was  a  small,  agreeable 
society  and  that  open-hearted,  kindly,  universal  hospi- 
tality still  so  characteristic  of  the  South  and  West. 

It  was  among  such  pleasant  folk  and  such  surround- 


XIX.  CENTURY.     DRAKE.  375 

ings  that  young  Drake  found  himself  when,  at  the  age  of 
nineteen,  he  finished  his  apprenticeship  and  began  to  prac- 
tise medicine  as  the  youthful  partner  of  Goforth.  The 
practice  and  the  partnership  at  that  time  were,  however, 
of  very  brief  duration.  Goforth  was  over  head  and  ears 
in  debt,  and  though  there  were  patients  in  plenty,  the 
arrangement  soon  became  profoundly  distasteful  to  the 
punctilious  and  ambitious  younger  man. 

Besides,  he  had  already  discovered  his  own  deficiencies 
of  education,  and  felt  the  futility  of  attempting  to  rise  in 
his  profession  without  academic  associations  or  the  dig- 
nity of  the  doctor's  degree.  But  he  continued  to  practise 
for  a  year,  trying  to  get  together  a  little  money.  Then 
he  started  East.  In  that  year  (1805)  there  was  but  one 
school  worthy  of  consideration,  —  that  of  Philadelphia. 
Harvard  was  struggling  into  life,  and  was  granting  a 
bachelor's  degree  only;  the  New  York  School  was  mori- 
bund, Dartmouth  was  as  yet  insignificant  and  unknown, 
and  the  neighboring  Transylvania  had  been  still-born 
some  six  years  before.  Pennsylvania  certainly  was  splen- 
didly pre-eminent  to  one  observing  it  from  another  region, 
as  did  Drake ;  and,  that  he  might  not  lack  the  dignity  of 
good  accomplished,  Goforth  issued  a  diploma  to  him  on 
the  eve  of  his  departure, — an  "  autograph  diploma  setting 
forth  his  (Drake's)  ample  attainments  in  all  the  branches 
of  the  profession,"  and  subscribed  himself  "  Surgeon- 
General  of  the  First  Division  of  Ohio  Militia.".  So 
Drake's  was  the  first  medical  diploma  ever  issued  in  Ohio, 
as  he  himself  had  been  the  first  medical  student  of  the 
State ;  and  Goforth  becomes  luminous  as  the  first  diploma 
manufacturer  of  the  West. 

The  Philadelphia  experience  w^as  mostly  a  disappoint- 
ment. Drake  went  there  in  the  late  autumn  and  lodged 
with  a  motherly  Mrs.  Brown,  who  mended  his  shirts  and 
cooked  his  breakfast;  he  attended  the  lectures  of  Rush. 
Woodhouse,  Wistar,  and  Physick,  paying  for  the  term's 


376  MEDICINE    IN   AMERICA. 

tuition  seventy  hard-earned  dollars.  He  learned  some- 
what of  the  ways  of  cities  and  men,  came  to  know  Barton 
the  distinguished  botanist,  who  treated  him  kindly,  and 
became  acquainted  with  young  Dudley,  of  Kentucky,  who 
was  there  on  the  same  errand  as  himself.  He  studied 
hard,  lived  sparingly,  spent  all  his  money,  made  no  effort 
to  secure  the  degree  at  that  time,  and,  after  six  months, 
returned  to  the  West. 

He  wanted  to  be  near  his  parents  after  the  six  years 
of  separation ;  so  for  a  year  he  settled  down  and  practised 
at  May's  Lick;  then  he  went  to  Cincinnati;  and  there, 
for  the  purposes  of  this  sketch,  he  remained  until  the  end 
of  his  life.  It  was  in  April,  1807,  that  he  took  up  his 
abode  there  once  more.  Two  days  later  he  wrote,  "  The 
town,  I  am  told  by  the  physicians  here,  is  very  healthy  at 
this  time.  How  I  shall  succeed  cannot  yet  be  determined. 
Several  persons  of  respectability  have  called  and  assured 
me  that  I  shall  have  their  patronage  and  support.  Upon 
the  whole,  appearances  are  rather  flattering."  Not  a  bad 
account  of  himself,  and  framed  in  words  well  chosen  for 
a  lad  but  seven  years  civilized.  Indeed,  that  command  of 
a  good  English  style,  with  clean-cut  phrasing,  is  one  of 
the  notable  things  about  this  self-made  man  of  action,  and 
his  clear,  bold  signature — "  Dan.  Drake" — is  still  to  be 
seen  in  his  manuscripts. 

Aside  from  practice,  which  began  promptly  to  flow  in 
upon  him,  Drake  mingled  constantly  in  the  best  society  of 
the  little  place,  and  we  hear  of  him  as  a  leader  in  the 
young  men's  debating  club,  of  which  he  said,  years  after- 
wards,^ "  I  can  recollect  no  association  for  mutual  im- 
provement except  this  primitive,  old-fashioned  organiza- 
tion, which  I  really  think  has  done  much  good  in  the 
world." 

As  might  be  expected,  the  next  thing  to  engage  the 


*  Discourse  before  the  Medical  Library  Association. 


XIX.  CENTURY.     DRAKE.  377 

twenty-two-year-old  doctor  was  matrimony.  Accord- 
ingly, he  became  a  constant  visitor  at  the  house  of  Colonel 
Jared  Mansfield,  the  government  Surveyor-General  for 
the  Northwestern  Territory;  the  chief  attraction  of  the 
house  being  Harriet  Sisson,  his  host's  youthful  niece. 
She  was  an  intelligent,  high-spirited,  charming  girl,  just 
the  wife  for  an  ambitious  man,  and  the  two  were  hap- 
pily married  in  the  autumn  of  1807. 

The  next  seven  years  were  devoted  to  a  growing  prac- 
tice, some  little  money-getting,  and  the  rearing  of  chil- 
dren. He  never  ceased  studying,  though,  following  the 
course  he  so  wisely  laid  down  twenty  years  later  in  his 
essay  on  Medical  Education.  Climatology,  botany,  and 
kindred  topics  absorbed  all  that  time  which  such  busy  men 
as  he  call  their  leisure,  and  three  years  after  his  marriage 
he  published  a  useful  little  volume,  entitled  "  Notices  of 
Cincinnati :  Its  Topography,  Climate,  and  Diseases." 
Five  years  later  there  appeared  his  more  ambitious  book, 
— "  Picture  of  Cincinnati  and  the  Miami  Country." 

Such  studies  and  such  essays  brought  the  young  man 
much  more  than  local  notice.  The  publications  were  read 
in  the  Eastern  States  and  even  made  their  way  to  Europe. 
No  similar  description  of  American  frontier  life  had  hith- 
erto appeared ;  and  scientists  and  scholars,  as  well  as  emi- 
grants and  promoters,  found  material  and  profit  in  these 
writings.  We  can  see  to-day  the  land  and  the  men  in  the 
convincing  pages;  and  perhaps  we  can  appreciate  even 
more  than  did  Drake's  contemporaries  the  pains  and  re- 
search involved  in  the  work, — the  exhaustive  marshalling 
of  facts  and  the  truthfulness  of  the  descriptions.  The 
young  West  certainly  had  developed  a  man  of  science. 

With  his  marriage  and  this  first  conspicuous  publication 
Drake  may  be  said  to  have  been  launched  finally  upon  pro- 
fessional life.  He  was  now  twenty-nine  years  old,  and 
his  occupations  as  author,  practitioner,  and  teacher  of 
medicine  constantly  increased  during  the  rest  of  his  life. 


378  MEDICINE    IN    AMERICA. 

He  was  a  voluminous  writer,  and  his  contributions  to 
medical  journals  in  the  form  of  essays,  reviews,  and  bib- 
liographical notices,  his  temperance  lectures,  and  his  pub- 
lic addresses  would,  if  collected,  says  Gross,  form  several 
large  octavo  volumes.  They  were,  during  the  early  years 
of  the  century,  very  valuable  contributions  to  medical 
progress  in  the  Middle  West,  and  though,  in  the  nature 
of  things,  eventually  ephemeral,  they  were  felt  to  be  very 
real  and  important  at  the  time. 

One  of  his  most  conspicuous  enterprises  as  a  writer  was 
the  founding,  in  1827,  of  the  Western  Journal  of  the 
Medical  and  Physical  Sciences,  a  useful  and  popular  peri- 
odical, which  was  continued  for  many  years.  During  the 
first  year  the  paper  was  edited  by  himself  and  James  C. 
Finley,  but  in  1828  he  assumed  the  sole  editorship,  which 
he  continued  until  1836.  This  work  absorbed  him  largely 
for  three  years  longer,  when,  owing  to  the  dissolution  of 
the  Medical  Department  of  the  Cincinnati  College,  the 
plant  was  transferred  to  Louisville  and  merged  in  the 
Western  Journal  of  Medicine  and  Surgery.  Drake  con- 
tinued as  an  editor  of  the  new  journal  until  1848,  when 
he  finally  withdrew  from  the  enterprise. 

As  he  developed  by  experience  and  contact  with  the 
world,  he  acquired  a  great  charm  of  manner,  which,  added 
to  his  native  sweetness  of  temper  and  his  simplicity, 
brought  a  popularity  with  all  sorts  and  conditions  of  men. 
There  was  no  mistaking  his  sincerity.  It  was  the  large, 
warm  heart  of  the  man,  worn  openly,  which  none  could 
fail  to  recognize,  that  gained  for  him  first  the  love  and 
affection  of  his  people ;  after  that,  his  abilities  and  powers 
made  themselves  known.  One  of  his  most  amiable  (|uali- 
ties  was  his  devotion  to  and  love  for  that  Western  land. 
Its  great  stretches  of  prairie  and  forest,  its  noble  rivers, 
its  lakes,  its  air,  its  climate,  and  its  people  were  very 
really  and  truly  dear  to  him,  and  in  his  earnest,  kindly 
way  he  was  forever  saying  so.     He  was  a  man  of  fine 


XIX.  CENTURY.     DRAKE.  379 

feelings  and  a  glowing  patriotism ;  he  realized  in  himself 
abilities  of  an  unusual  order,  and  so  early  set  before  him- 
self, for  his  life-work,  two  great  undertakings, — the  up- 
building of  medical  education  in  the  West  and  his  monu- 
mental volumes  on  the  "  Diseases  of  the  Interior  Valley 
of  North  America."  The  two  topics  do  not  seem  to  lend 
themselves  readily  to  entertaining  description,  but  the 
enthusiasm  of  the  man  and  his  original  endeavors  illu- 
mine the  ponderous  themes. 

Let  us  follow  these  two  lines  of  his  life-work,  then, 
noting  briefly  what  he  accomplished  and  in  what  he 
failed. 

In  1 81 5,  as  he  had  not  yet  received  a  medical  degree, 
he  went  back  to  Philadelphia  for  a  session  of  study. 
Already  widely  known  for  his  writings,  he  found  him- 
self much  more  of  a  personage  than  was  the  simple  boy 
of  ten  years  earlier;  but  he  withstood  outside  attrac- 
tions, he  stuck  to  his  books,  and  in  a  few  months  secured 
a  diploma  from  the  University.  In  May,  1816,  he  re- 
turned to  Cincinnati,  and  soon  became  involved  in  the 
ambitious  projects  which  occupied  the  remainder  of  his 
life. 

Drake  was  plunged  into  teaching  in  181 7,  and  this  is 
the  manner  in  which  the  amazed  young  man  announced 
the  fact  to  one  of  his  friends :  "I  am  now  going  to 
astonish  you, — so  cling  hold  of  every  support  within  your 
reach, — I  am  a  Professor!  Yes,  incredible  as  it  may 
appear  to  you  and  my  other  intimate  friends,  /  am  really 
and  bona  fide  appointed  a  Professor;  and  I  repeat  it  on 
this  side  of  the  sheet  to  save  you  the  trouble  of  turning 
back  to  see  whether  your  eyes  did  not  deceive  you.  I  am, 
let  me  repeat,  unquestionably  a  Professor.  ...  In  Lex- 
ington (Kentucky)  there  has  been  for  many  years  an 
incorporated  seminary  styled  the  Transylvania  Univer- 
sity. .  .  .  The  trustees  have  established  a  faculty  of  med- 
icine.   The  Professorship  of  Materia  Medica  and  Botany 


38o  MEDICINE    IN    AMERICA. 

is  the  chair  they  have  ojffered  to  me,  and  five  days  ago  I 
signified  my  acceptance."  He  renewed  a  partnership  with 
his  old  master,  Goforth,  now  returned  from  profitless 
wanderings,  and  so,  dropping  practice  for  half  the  year, 
he  proceeded  to  Lexington  for  the  winter's  work. 

We  have  heard  something  of  that  Lexington  School 
before,  and  of  the  doings  and  duellings  of  the  diligent 
Dudley.  They  used  to  call  Lexington  the  Athens  of 
the  West,  and  that  Transylvania  University  was  the 
Acropolis. 

Drake  took  his  place  modestly  among  the  little  com- 
pany who  served  there,  and  began  to  teach  the  rude  youth 
of  the  land. 

He  moved  his  family  to  the  town;  he  prepared  him- 
self for  what  he  expected  would  be  his  life-work;  he 
taught  zealously  and  successfully  for  a  term,  and  then  left 
it  all  in  disgust. 

His  enemies  used  to  say  that  he  was  too  much  of  an 
autocrat, — that  he  would  never  serve  where  he  could  not 
have  a  free  hand.  This  seems  severe  on  a  person  whom 
his  friends  described  as  the  most  mild-mannered  of  men. 
The  trouble  he  found  with  the  Transylvania  School  seems 
to  have  been  the  bumptiousness  of  Dudley.  That  restless 
enthusiast  was  in  hot  water  with  his  colleagues  so  long- 
as  he  lived  and  taught.  Drake  recognized  this  impos- 
sible characteristic  of  his  associate,  and  wisely  decided  to 
avoid,  by  flight,  any  chance  of  hostilities. 

From  now  on,  and  for  many  years,  he  flitted  from 
school  to  school ;  founding,  strengthening,  struggling, 
and  resigning  to  such  an  extent  that  it  is  hard  to  see  how 
he  ever  could  have  made  time  to  establish  his  reputation 
as  a  great  teacher ;  to  that  greatness  his  pupils  have  borne 
abundant  testimony.  He  had  the  rare  trait — the  first 
requisite  in  a  successful  teacher — of  sliowing  an  earnest, 
whole-souled  desire  that  his  students  should  know  what 
he  knew.    He  did  not  value  himself  for  his  own  holdings- 


XIX.  CENTURY.     DRAKE.  381 

forth,  but  for  the  results  of  his  teaching  as  the  pupils 
showed  them. 

He  was  in  constant  protest  against  the  preposterous 
system  of  his  day,  which  threw  all  classes  of  students — 
Juniors  and  Seniors  alike — into  the  same  lecture-room, 
to  pick  up  what  scant  knowledge  they  might.  He  appre- 
ciated the  advantages  of  a  graded  course,  and  of  sepa- 
rating the  beginners  from  the  more  advanced,  though  he 
was  not  destined  to  see  that  change  take  place. 

He  protested,  too,  against  the  ignorance  and  illiteracy 
of  the  young  men  as  they  came  to  the  Medical  Schools. 
Little  beyond  the  elements  of  reading  and  writing  were 
demanded  of  them,  so  that  a  broad  and  philosophic  view 
of  science  was  forever  denied  them.  Their  first  two  or 
three  terms,  consequently,  were  occupied  in  trying  to  mas- 
ter the  meaning  of  what  they  were  set  to  do ;  and  it  was 
not  until  the  latter  part  of  their  course  that  they  were 
able  to  gather  any  great  benefit  from  the  lectures. 

Considering  the  sort  of  student  material  with  which 
they  had  to  deal,  therefore,  perhaps  the  system  of  those 
old  professors  was  well  enough.  They  gave  the  same 
lectures  to  the  same  students  for  two  successive  sessions, 
and  trusted  that  by  the  end  of  the  repetition  something 
of  knowledge  might  have  sunk  in.  Most  of  them,  how- 
ever, out  of  consideration  for  the  inexperienced  new-- 
comers, kept  their  utterances  at  an  elementary  level. 

Drake  refused  to  be  confined  to  any  such  limits.  He 
lectured  for  the  best  of  his  students,  not  for  the  worst. 
So  the  beginners  under  him  sat  in  dull  and  floundering 
puzzlement ;  but  the  Seniors  and  young  graduates  adored 
him. 

Probably  the  fundamental  reason  for  Drake's  frequent 
changes  of  scene  was  his  high  ideal  of  what  a  Medical 
School  should  be.  Most  of  the  small  schools  of  that  time 
were  private  enterprises,  conducted  as  businesses  by  a 
small  body  of  men,  and  the  profits  derived  from  the  stu- 


382  :^IEDICINE    IN    AMERICA. 

dents'  fees  were  divided  among  the  teachers.  Naturally, 
the  average  teacher  was  ambitious  of  attracting  pupils, 
and  subordinated,  if  he  did  not  actually  prostitute,  sci- 
ence to  this  motive.  With  such  purposes  Drake  had  n(3 
sympathy.  He  was  lx)rn  with  the  true  spirit,  and  the 
machinations  of  many  of  his  colleagues  disgusted  and 
offended  him. 

Some  such  reason  was  at  the  bottom  of  his  resignation 
from  the  Lexington  School.  He  writes  to  a  friend :  "  On 
the  23d  of  March,  being  dissatisfied  with  the  Medical  Col- 
lege, and  not  relishing  the  idea  of  a  removal  to  a  strange 
town,  of  prospects  inferior  to  those  of  Cincinnati,  I  re- 
signed my  professorship." 

A  great  Western  school  was  his  ambition,  but  it  was  not 
to  rise  in  Lexington. 

Though  disappointed  with  such  experiences,  Drake  was 
not  in  the  least  discouraged  with  teaching.  No  sooner 
had  he  returned  to  Cincinnati,  in  1819,  than  he  set  about 
promoting  a  medical  school  and  hospital  there,  the  school 
to  be  called  the  Medical  College  of  Ohio.  A  considerable 
endowment  was  secured  and  a  charter  from  the  Legisla- 
ture obtained  through  his  exertions.  Though  so  far  suc- 
cessful, however,  he  met  constantly  the  opposition  of  two 
of  his  colleagues,  who  worked  together  to  secure  control 
of  the  new  institution. 

In  consequence  of  these  personal  controversies,  the 
School  did  not  get  under  way.  as  it  should  have  done,  in 
the  autumn  of  1819;  but  in  1820  the  new  faculty  was 
organized,  and  the  School  opened  with  Drake  as  Profes- 
sor of  the  Institutes  and  Practice  of  Medicine. 

Rohrer  held  the  chair  of  Materia  Medica  and  Phar- 
macy. Jesse  Smith  was  Professor  of  Anatomy  and  Sur- 
gery, and  Elijah  Slack,  A.M., was  Professor  of  Chemistry 
and  President  of  the  Cincinnati  College.  From  the  start 
Drake  was  the  moving  spirit  in  educational  matters, 
though  he  proved  to  be  as  clay  in  the  hands  of  the  medical 


XIX.  CENTURY.     DRAKE.  383 

politicians.  He  believed  firmly  that  Cincinnati  was  to  be 
the  site  of  the  great  Western  Medical  College  of  which 
he  dreamed,  and  while  he  lived  he  clung  to  that  idea.  He 
said  that  the  reasons  for  a  great  school  there  lay  in  "  the 
obvious  and  increasing  necessity  for  such  an  institution  in 
the  Western  country,  and  the  peculiar  fitness  and  advan- 
tages of  this  city  for  the  successful  execution  of  their 
project.  These  are :  its  central  situation,  its  northern 
latitude,  its  easy  water  communications  with  most  parts 
of  the  Western  country,  and,  above  all,  the  comparatively 
numerous  population.  .  .  .  The  professors  placed  on  this 
ample  theatre  will  therefore  have  numerous  opportunities 
of  treating  a  great  variety  of  diseases.  .  .  .  Finally, 
every  medical  man  will  perceive  that,  amidst  so  mixed  and 
multiplied  a  population,  the  opportunities  presented  to  the 
Western  student  for  the  study  of  practical  anatomy  will 
altogether  transcend  any  which  he  can  enjoy  without 
visiting  and  paying  tribute  to  the  Schools  of  the  Atlantic 
States." 

Most  unfortunately  for  the  School  and  for  Drake  him- 
self, a  strong  party  in  the  faculty,  backed  by  influential 
friends  among  the  laity,  was  promptly  organized  to  op- 
pose and  thwart  him,  and,  when  their  power  was  seen  and 
their  minor  purposes  proved  successful,  they  proposed  to 
get  rid  of  him  altogether. 

Drake  held,  by  law,  the  senior  place  in  the  little  faculty 
and  was  their  president.  That  fact  did  not  at  all  dismay 
his  opponents.  During  the  second  term  of  the  new 
School,  at  one  of  the  regular  faculty  meetings,  while 
Drake  was  in  the  chair,  a  motion  for  his  expulsion  was 
introduced.  He  was  obliged  to  put  the  question,  and  it 
was  promptly  carried.  As  his  biographer  says.  "  Such  an 
act  shocked  the  public  mind,  and  is  an  illustration  of  the 
loose  morals  as  well  as  bitter  controversy  not  uncommon 
in  the  medical  profession." 

At  any  rate,  that  was  the  end,  for  the  time  being,  of  the 


384  MEDICINE    IN    AMERICA. 

Medical  College  of  Ohio.  It  was  started  again  after  some 
time,  but  in  the  hands  of  responsible  trustees,  of  whom 
General  Benjamin  Harrison  was  the  head,  and  of  its  sub- 
sequent career  we  shall  hear  something  later. 

For  two  years  after  this  abrupt  dismissal  from  his  pro- 
fessorship Drake  led  a  quiet  life  in  Cincinnati,  retired 
from  active  conflict,  and  attending  to  his  own  profes- 
sional affairs.  Then,  in  1823,  he  was  again  called  to  Lex- 
ington. 

Whatever  may  have  been  the  actual  and  prospective 
relative  merits  of  Cincinnati  and  Lexington,  there  is  not 
the  slightest  doubt  that  the  Transylvania  School  in  that 
third  decade  of  the  last  century  entirely  outclassed  the 
Ohio  College.  It  was  officered  by  men  of  ability  and 
attainments ;  some  of  them  men  of  national  reputation  be- 
fore or  since.  Holly,  of  Boston,  had  recently  gone  there 
as  head  of  the  Academical  Department ;  our  old  acquaint- 
ance, Charles  Caldwell,  was  Dean  and  Professor  of  the 
Institutes  of  Medicine;  Dudley,  of  course,  continued 
in  the  chair  of  Anatomy  and  Surgery,  and  William  H. 
Richardson  in  that  of  Obstetrics.  To  Drake  was  assigned 
the  chair  of  Materia  Medica  and  Medical  Botany.  Two 
years  later,  in  1825,  on  the  resignation  of  Samuel  Brown, 
Professor  of  the  Theory  and  Practice  of  Medicine,  Drake 
was  transferred  to  the  vacancy,  and  there  he  remained 
until  his  resignation  from  the  School  in  1827. 

Those  four  were,  among  the  most  successful  teaching 
years  of  Drake's  career.  He  was  thirty-eight  years  old 
when  he  went  to  Lexington,  full  of  fresh  energy  and  am- 
bition, and  at  the  height  of  his  powers. 

During  those  Lexington  years  he  must  have  passed  his 
time  most  agreeably  with  congenial  associates.  With 
Caldwell  he  was  on  good  terms,  though  that  eccentric 
man's  views  on  phrenology,  on  spontaneous  generation, 
and  on  disease  in  general  differed  as  radically  from  his 


XIX.  CENTURY.     DRAKE.  385 

own  as  they  did  from  those  of  most  careful  thinkers,  even 
in  that  era  of  extravagant  and  daring  speculation. 

During  those  years,  too,  he  began  the  series  of  extended 
journeys  which  were  undertaken  in  connection  with  his 
great  book  on  Diseases  of  the  Mississippi  Valley.  Those 
travels,  his  increasing  consulting  practice,  which  took  him 
far  from  his  base,  his  growing  interest  in  large  public 
enterprises,  and  his  literary  activities  induced  him,  after 
four  years,  to  settle  again  in  Cincinnati,  and  there  accord- 
ingly we  find  him  in  1827. 

There  he  seems  to  have  worked  steadily  and  agreeably 
until  1830,  when  we  see  him  suddenly  transferred  to  a 
still  broader  field,  and  his  fifth  professorship,  the  chair 
of  Medicine  in  the  new  Jefferson  College  in  Philadelphia. 
For  some  reason  which  does  not  appear,  Drake  went  to 
Philadelphia  with  no  intention  of  staying  there  perma- 
nently. It  seems  likely  that  he  was  growing  restless  for 
his  beloved  teaching,  and  took  up  the  work  at  Jefferson  as 
a  pastime  until  he  could  find  something  more  to  his  mind. 
The  School  started  the  term  with  about  one  hundred  stu- 
dents, and,  from  all  accounts,  Drake  was  immediately  as 
popular  with  them  as  he  had  been  with  his  previous 
classes.  He  resigned  before  the  year  was  over,  however, 
and  hurried  back  with  new  schemes  to  Cincinnati. 

Of  course,  the  only  point  of  interest  for  us  in  this  ex- 
perience of  Drake's  is  the  fact  that  he  should  have  been 
called  East  at  all,  and  the  evidence  therein  of  his  salient 
work  and  wide  reputation. 

He  left  Philadelphia  to  found  another  medical  school, 
— this  was  a  little  thing, — to  be  mentioned  here  and  dis- 
missed. It  was  to  be  a  department  of  Miami  University, 
at  Oxford,  Ohio.  The  scheme  fell  through  at  once,  for 
the  friends  of  the  College  of  Ohio  saw  in  Miami  a  dan- 
gerous rival,  and  broke  it  up  by  offering  positions  in  their 
own  faculty  to  the  Miami  teachers.     The  teachers  went, 

25 


386  MEDICINE    IX    AMERICA. 

and  with  them  meekly  went  Drake.     It  was  for  a  few 
weeks  only,  and  at  the  end  of  the  session  he  resigned. 

Four  years  later  he  went  at  his  teaching  again  with 
renewed  enthusiasm.  He  was  convinced  that  the  ■Medical 
College  of  Ohio  was  never  to  succeed  as  it  was  then  man- 
aged, and,  jealous  for  the  reputation  of  his  beloved  Cin- 
cinnati, he  attempted  to  square  the  conditions  by  organ- 
izing a  medical  department  in  the  Cincinnati  College.  If 
talent  could  count,  the  new  ^•enture  should  have  been  a 
brilliant  success,  for  Drake  gathered  about  him  a  very 
able  and  enthusiastic  corps  of  teachers, — young  men  who 
gave  the  School  a  great  reputation  throughout  its  brief 
career,  and  became  later  well  known  in  wider  fields. 

Drake  himself  took  the  chair  of  Medicine ;  L.  C.  Rives, 
the  distinguished  obstetrician,  became  Professor  of  Ob- 
stetrics. Other  familiar  names  were  those  of  J.  N.  Mc- 
Dowell, J.  P.  Harrison,  James  B.  Rogers,  later  of  the 
University  of  Pennsylvania ;  Horatio  G.  Jameson,  so  long 
famous  in  Baltimore;  Samuel  D.  Gross,  the  eminent  sur- 
geon and  bibliographer;  and  Willard  Parker,  who  was 
for  years  an  ornament  of  the  profession  in  New  York 
City.  And  it  is  worth  remembering  that  the  chair  to 
which  Gross  was  assigned  was  that  of  Pathological  Anat- 
omy,— the  first  of  the  kind  established  in  this  country. 

Of  all  Drake's  teaching  experiences  and  experiments, 
this  of  Cincinnati  College  was  the  most  promising  in  con- 
ception and  in  immediate  results.  He  was  given  a  free 
hand ;  indeed,  Rives,  McDowell,  Gross,  and  himself  were 
the  projectors  and  chief  supporters  of  the  School.  He 
was  surrounded  by  an  able  and  congenial  company  of 
teachers;  but,  most  unfortunately,  the  School  contained 
within  itself  the  elements  of  failure, — the  same  elements 
which  had  wrecked  so  many  other  promising  schools 
throughout  the  land, — it  was  a  private  venture.  Already 
in  1835  the  elalx)ration  of  scientific  study  and  teaching 
had  advanced  so  far  beyond  the  primitive  days,  when  all 


XIX.  CENTURY.     DRAKE.  387 

a  school  needed  was  the  man,  that  without  proper  labora- 
tories, buildings,  and  their  equipment,  together  with  an 
endowment  to  carry  them  on,  it  was  found  impossible  to 
succeed. 

The  enterprise  should  have  succeeded.  It  embraced 
the  ablest  body  of  teachers  as  yet  gathered  in  the  new 
West;  enthusiasm,  training,  spirit,  and  audiences,  all 
were  there;  but  the  community  failed  to  support  them, 
and  after  four  brilliant  years  of  constantly  increasing 
fame  the  project  came  to  an  end. 

A  contributing  cause  of  this  failure  was  lack  of  business 
sagacity.  Drake  was  no  business  man  in  the  narrow  sense. 
He  had  imagination  and  the  gifts  of  the  prophet,  but  he 
could  not  make  his  books  balance.  That  was  one  of  his 
misfortunes  through  life.  Great  business  schemes,  for 
which  Cincinnati  still  stands  his  debtor,  failed  while  in 
his  promoting  hands.  His  sanguine  nature  shirked 
detail. 

So  the  little  faculty  was  scattered, — Rives  to  the  Col- 
lege of  Ohio,  McDowell  to  the  University  of  Missouri, 
Rogers  and  Gross  to  Philadelphia,  Jameson  to  Baltimore, 
Willard  Parker  to  New  York,  and  Drake  himself  to  the 
University  of  Louisville,  where  was  created  for  him  the 
novel  chair  of  Clinical  Medicine  and  Pathological  Anat- 
omy. In  that  he  taught  until  1844,  when,  on  the  retire- 
ment of  his  colleague  Cooke,  he  was  transferred  to  the 
chair  of  Medicine,  which  he  filled  until  1849,  when  he  re- 
signed just  before  reaching  the  age  of  sixty-five,  which 
had  recently  been  fixed  by  the  Trustees  as  the  age  of 
retirement.  It  was  a  good  rule,  but  acted  to  the  disad- 
vantage of  the  School  in  this  first  instance,  for  the  Trus- 
tees lost  their  strongest  teacher. 

The  winter  before  Drake's  resignation  he  was  lecturing 
to  a  class  of  four  hundred, — up  to  that  time  the  largest 
Western  class  of  record. 

With  bewildering   facility  Drake   immediately   found 


388  MEDICINE   IN    AMERICA. 

another  professorship;  this  time  in  the  still  floundering 
]\Iedical  College  of  Ohio,  which  he  had  founded  thirty 
years  before.  Strangely  enough,  and  in  spite  of  the 
scur\7-  treatment  he  had  received  from  the  Ohio  College, 
Drake  seems  always  to  have  loved  it, — at  least,  he  says 
so.  In  his  introductory  lecture  there  at  this  time  he 
told  in  brief  outline  the  story  of  his  teaching  career,  and 
how  always,  in  his  wanderings,  his  heart  had  turned  back 
constantly  to  this  first  affection. 

He  had  returned  to  his  early  home  and  his  early  school 
with  the  applause  and  cordial  good-will  of  all  who  looked 
on,  his  old  enemies  included;  yet  even  now  he  stayed  but 
one  term. 

The  next  year  he  was  recalled  to  Louisville,  the  Trus- 
tees of  the  College  there  having  revoked  their  rule  of  an 
age  limitation  for  the  teachers ;  there  he  remained  for  two 
sessions,  when  he  again  returned,  in  1852,  to  Cincinnati 
and  his  chair  in  the  Ohio  College,  now  reorganized,  with 
a  strong  faculty  and  under  brighter  auspices.  Here  it 
was,  just  at  the  beginning  of  the  session,  full  of  hope  and 
energ}'  and  new  ambition,  that  he  came  to  the  end  of  his 
labors.     He  died  of  acute  meningitis. 

At  the  time  of  his  death,  which  took  place  on  the  6th 
of  November,  1852,  he  had  just  completed  his  sixty- 
seventh  year.  But  he  was  not  "  due  to  die."  Much  work 
still  claimed  the  man.  and  his  taking  off  seemed  untimely. 

Drake's  teaching  career  was  so  long,  so  varied,  and  so 
full  of  startling  changes  that  it  is  impossible,  with  interest, 
to  follow  it  in  detail.  But  in  spite  of  this  he  was  always 
a  great  and  growing  power  for  good  in  that  Western 
country.  He  came  in  contact  with  many  hundreds  of 
young  men  under  many  and  varied  conditions,  and  he 
always  brought  them  a  message  worth  their  hearing.  He 
taught  what  all  great  teachers  have  taught, — a  love  of  his 
profession  and  of  science  for  its  own  sake ;  that  the  art 
truly  is  long  and  not  lightly  to  be  attempted,  and  that, 


XIX.  CENTURY.     DRAKE.  389 

even  so,  the  faithful  physician  in  deaHng  with  his  kind 
must  place  the  humanities  before  all  else. 

So,  though  he  was  found  testifying  to  many  men  and 
in  diverse  places,  his  message  was  always  the  same ;  and, 
as  the  perverse  Fates  would  have  it,  he  tarried  longest 
and  taught  the  most,  not  in  his  beloved  Cincinnati,  but 
in  the  neighboring  Louisville,  where  he  labored  more  than 
ten  years. 

It  was  in  Louisville,  too,  that  he  wrote  the  most  of  that 
monumental  work  which  men  said  would  make  him  im- 
mortal, "Sic  Transit;"  and  he  wrote  it  while  looking 
always  back  to  the  Ohio  shore.  It  was  the  work  of  his 
prime  and  his  old  age.  Here  is  what  he  told  his  students 
of  the  Ohio  College  about  those  days  when  he  went  wan- 
dering about  the  world;  it  is  florid  talk,  but  one  finds  it 
ringing  true. 

"  My  heart  still  fondly  turned  to  my  first  love,  your 
alma  mater.  Her  image,  glowing  in  the  warm  and  radiant 
tints  of  earlier  life,  was  ever  in  my  view.  Transylvania 
had  been  reorganized  in  1819,  and  included  in  its  faculty 
Professor  Dudley,  whose  surgical  fame  had  already 
spread  throughout  the  West.  In  the  year  after  my  sepa- 
ration from  this  School  I  was  recalled  to  that ;  but  neither 
the  eloquence  of  colleagues,  nor  the  greeting  of  the 
largest  classes  which  the  University  ever  enjoyed,  could 
drive  that  beautiful  image  from  my  mind.  ...  I  was 
subsequently  called  to  Jefferson  Medical  College,  Phila- 
delphia; but  the  image  mingled  with  my  shadow.  And 
when  we  reached  the  summit  of  the  mountain,  it  bade 
me  stop  and  gaze  upon  the  silvery  cloud  which  hung  over 
the  place  where  you  are  now  assembled.  Afterwards,  in 
the  Medical  Department  of  Cincinnati  College,  I  lectured 
with  men  of  power;  but  the  image  still  hovered  around 
me.  I  was  then  invited  to  Louisville,  became  a  member 
of  one  of  the  ablest  faculties  ever  embodied  in  the  West, 
and  saw  the  halls  of  the  University  rapidly  filled.     But 


390  MEDICINE    IN    AMERICA. 

when  I  looked  in  the  faces  of  four  hundred  students,  be- 
hold, the  image  was  in  their  midst.  While  there  I  prose- 
cuted an  extensive  course  of  personal  inquiry  into  the 
causes  and  cure  of  the  diseases  of  the  interior  of  the  con- 
tinent; and  in  journeying  by  day  and  journeying  by 
night, — on  the  water  and  on  the  land, — while  struggling 
through  the  matted  rushes  where  the  Mississippi  mingles 
with  the  Gulf,  or  camping  with  Indians  and  Canadian 
boatmen  under  the  pines  and  birches  of  Lake  Superior, 
the  image  was  still  my  faithful  companion,  and  whispered 
sweet  words  of  encouragement  and  hope.  I  bided  my 
time ;  and  after  twice  doubling  the  period  through  which 
Jacob  waited  for  his  Rachel,  the  united  voice  of  the  Trus- 
tees and  Professors  has  recalled  me  to  the  chair  which  I 
held  in  the  beginning." 

To  him  who  reads,  the  image  is  not  altogether  clear; 
but  the  sentiment  is ;  and  the  little  paragraph  is  articulate 
of  the  purposes,  vicissitudes,  and  accomplishments  of  the 
man's  life. 

It  was  in  the  early  twenties  that  Drake  announced  his 
plan  of  writing  a  great  work  on  the  "  Diseases  of  the  In- 
terior Valley  of  North  America,"  but  he  did  not  publish 
it  until  1850.  It  was  a  great  ambition.  Even  now  it  is 
fair  to  rank  the  volumes  among  our  few  American  Medi- 
cal Classics,  to  be  placed  on  our  shelves  with  Morgan's 
"  Discourse  on  Medical  Education,"  John  Jones  on  the 
"  Treatment  of  Wounds,"  Bard's  "Angina  Suffocativa," 
Bond's  "  Study  of  Clinical  Medicine,"  the  writings  of 
Rush,  Nathan  Smith,  Bartlett,  Carey,  Currie,  James 
Jackson,  Ramsay,  Thacher,  and  half  a  dozen  others.  We 
cannot  make  a  great  list,  but  we  can  make  a  strong  one, 
and  that  work  of  Drake  is  among  the  strongest.  In  size, 
at  least,  it  is  not  lacking,  for  it  comprises  two  great  vol- 
umes of  near  a  thousand  pages  each. 

It  was  the  success  of  his  "  Picture  of  Cincinnati"  that 
.stimulated  Drake  to  his  greater  work,  and  the  latter  grew 


XIX.  CENTURY.     DRAKE.  391 

out  of  the  former.  Truly,  it  was  the  work  of  a  pioneer. 
There  were  no  books  to  be  consulted.  He  was  cultivating 
a  virgin  soil.  It  meant  for  him  years  of  investigation 
and  thousands  of  miles  of  travel.  He  geologized,  bota- 
nized, and  surveyed.  He  visited  hamlets  and  cities,  hos- 
pitals and  wigwams ;  he  sailed  lakes,  rivers,  and  seas ;  he 
tramped  forests,  prairies,  mountains,  and  swamps;  he 
consulted  with  scientists  in  their  laboratories,  with  In- 
dians about  their  fires;  he  mingled  with  country  doctors, 
with  soldiers  and  trappers;  with  miners,  frontiersmen, 
and  Canadian  voyageurs.  He  covered  the  whole  land 
systematically,  painfully,  faithfully,  from  Hudson  Bay  to 
the  Gulf  and  from  the  mouth  of  the  St.  Lawrence  to  the 
head-waters  of  the  Missouri, 

Besides  numerous  brief  excursions  and  the  conduct  of 
an  enormous  correspondence,  Drake  visited,  in  the  ten 
years  between  1840  and  1850,  Louisiana,  Florida,  Missis- 
sippi, Alabama,  the  waters  of  the  Gulf  of  Mexico,  Ken- 
tucky, Tennessee,  North  and  South  Carolina,  Virginia, 
Pennsylvania,  New  York,  Illinois,  Indiana,  Michigan, 
Iowa,  Wisconsin,  Missouri,  the  Great  Lakes,  and  Canada. 
He  travelled  on  horseback,  on  foot,  by  railway,  steamboat, 
stage-coach,  and  canoe.  He  was  indefatigable;  he  en- 
dured all  things.  Wherever  he  went  in  civilized  regions 
his  fame  preceded  him,  and  he  met  with  unfailing  cor- 
diality and  encouragement.  Even  in  the  wilds  of  the 
Northwest  and  in  the  swamps  of  the  Gulf  Coast,  the 
ignorant  Indians  and  negroes  came  to  feel  for  him  an 
instant  respect  and  admiration. 

During  these  journey ings  he  was  always  writing,  and 
much  of  his  material,  in  the  form  of  letters  and  editorials, 
was  published  in  his  own  Western  Journal  of  Medicine 
and  Surgery,  at  Cincinnati.  Those  papers  of  his  make 
that  periodical  one  of  the  most  interesting  scientific  jour- 
nals of  the  time.  They  are  full  of  strong,  original  obser- 
vations and  records, — dealing  with  men  and  manners. 


392  MEDICINE    IN   AMERICA. 

with  peoples  and  lands,  with  wild  creatures  and  seasons, 
with  the  great  forces  of  nature,  and  with  the  diseases 
from  which  folk  suffered  in  those  widely  distant  parts. 

To  the  man  who  has  not  himself  travelled  those  vast 
regions,  it  is  impossible  to  convey  an  adequate  idea  of  the 
magnitude  of  Drake's  labors,  beside  which  those  of  Her- 
cules himself  seem  very  modest  affairs.  His  observa- 
tions were  never  superficial  nor  his  progress  hasty.  He 
stopped  at  all  the  villages,  he  explored  all  the  streams, 
he  climbed  all  the  hills  of  which  he  writes,  and  he  talked 
with  every  man  who  had  anything  to  tell  him  of  the  busi- 
ness in  hand. 

Truly,  if  he  had  done  nothing  more  than  explore,  he 
would  still  remain  to  us  one  of  the  notable  characters  of 
American  medicine ;  but  he  wrote  about  it  all,  and  we  still 
take  down  his  volumes  from  our  shelves. 

For  us  the  interest  in  Drake's  great  work  is  historical 
rather  than  immediately  practical.  His  chapters  cover  in 
exhaustive  detail  the  topography  of  the  regions  described, 
together  with  a  brief  account  of  the  diseases  peculiar  to 
those  various  regions ;  and  tell  how  the  diseases  assumed 
different  characteristics,  according  to  the  changed  condi- 
tions of  geography  and  race  affected;  for  his  purpose 
was  to  point  out  especially  the  peculiarities  of  the  Cauca- 
sian's ailments  as  compared  with  those  of  the  Indian  and 
Negro. 

He  then  devoted  many  chapters  to  Climatic  Etiology 
and  Physiological  and  Social  Etiology. 

His  second  book  deals  with  febrile  diseases,  especially 
"  Autumnal  Fever,"  "  Yellow  Fever,"  "  Typhus  Fevers," 
"  Eruptive  Fevers,"  "  Phlogistic  Fevers,"  and  "  Phleg- 
masia." 

Drake's  old  friend  Gross,  commenting  on  these  two 
volumes,  says,  "  The  two  together  constitute  a  monu- 
ment of  the  genius  and  industry  of  their  author  as  dura- 
ble as  the  mountains  and  the  valleys,  whose  medical  his- 


XIX.  CENTURY.     DRAKE. 


393 


tory  they  are  designed  to  portray  and  illustrate.  The  toil 
and  labor  expended  upon  their  production  afford  a  happy 
exemplification  of  what  may  be  accomplished  by  the  well- 
directed  and  persistent  efforts  of  a  single  individual,  un- 
aided by  wealth  and  unsupported  by  the  patronage  of  his 
profession." 

The  second  part  of  the  estimate  is  doubtless  true. 

Now.  Drake  was  more,  even,  than  a  brilliant  teacher 
and  a  voluminous  writer.  He  was  an  enthusiastic,  public- 
spirited  citizen,  and  man  of  affairs.  A  recent  reviewer 
has  said  that  he  made  Cincinnati  what  she  is.  Though 
Cincinnati  would  have  thriven  without  Drake,  she  does 
owe  him  much  for  stimulating  her  infancy,  and  the  list 
of  his  enterprises  would  be  a  long  one.  He  is  described  as 
a  man  of  not  one,  but  many,  characteristics.  His  very 
look,  manner,  step,  and  gesture  were  characteristic, — 
the  outward  signs  of  his  peculiar  nature.  So,  too,  his  con- 
versation, voice,  and  modes  of  expression  all  tended  to 
stamp  him  as  an  extraordinary  personage.  But  there 
was  one  feature  standing  out  prominently  which  distin- 
guished him  from  many  men,  and  that  was  concentra- 
tion, strenuousness,  intensity  of  thought,  action,  and 
purpose.  It  was  this,  doubtless,  that  made  for  what- 
ever of  success  or  failure  came  to  him.  It  showed  in  his 
devotion  to  his  family,  his  loyalty  to  friends,  his  love  for 
his  profession,  his  power  as  a  teacher,  his  ability  as  a 
writer,  his  zeal  as  a  promoter,  his  hatred  of  the  ignoble. 
He  was  forever  throwing  himself  into  the  breach ;  and  in 
this  way,  though  the  sum  of  his  accomplishments  was 
great,  he  wasted  through  life  more  superb  energy  than  is 
given  to  most  of  us  for  positive  success. 

In  early  life,  not  content  with  a  growing  professional 
reputation,  he  established  in  business,  under  their  joint 
names,  a  younger  brother ;  and  through  the  failure  of  the 
enterprise  he  became  involved  in  years  of  grievous  anxiety 
and  grave  financial  loss.    Again,  when  a  mature  man,  in 


394  MEDICINE    IN   AMERICA. 

1835,  he  enlisted  the  enthusiasm  of  the  people  of  the 
South  in  a  great  railway  system  which  should  unite  the 
Ohio  River  with  the  tide-waters  of  the  Carolinas  and 
Georgia.  At  a  mass  meeting  of  his  fellow-townsmen  he 
presented  an  elaborate  report  upon  the  subject,  pointing 
out  the  commercial,  social,  and  political  advantages  of 
such  a  road,  and  concluded  with  an  eloquent  appeal  to 
the  people  of  the  different  States  to  be  benefited.  Later, 
at  Knoxville,  Tennessee,  he  addressed  a  large  meeting  of 
those  interested  in  the  scheme,  and  was  received  with 
great  encouragement. 

The  project  failed,  however,  owing  to  the  jealousy  of 
Kentucky,  which  could  not  be  persuaded  to  grant  the  road 
the  necessary  right  of  way. 

As  we  should  expect,  however,  the  most  important  pub- 
lic activities  of  Drake  were  in  connection  with  the  chari- 
table and  educational  foundations  of  Cincinnati.  A  mere 
enumeration  of  some  of  these  must  suffice.  He  was  a 
promoter  of  the  "  Western  Literary  Institute  and  College 
of  Professional  Teachers."  He  gave  a  number  of  con- 
spicuous addresses  before  this  body,  and  Gross  says  of 
him,  "  The  first  time  I  ever  heard  him  speak  in  public  was 
at  a  meeting  of  the  College  in  1834,  and  I  well  remember 
how  completely  he  enchained  the  vast  audience." 

In  1 82 1  he  brought  about  the  establishment  of  the 
Commercial  Llospital  of  Ohio,  a  foundation  as  old  as  the 
Massachusetts  General  in  Boston,  and  he  was  one  of  its 
physicians  through  most  of  his  life. 

In  1827  he  established  the  Cincinnati  Eye  Infirmary. 
It  was  extremely  successful,  and  Drake,  a  member  of  the 
staff  for  a  time,  was  famous  in  the  region  as  a  bold  and 
skilful  ophthalmic  surgeon.  Later,  while  living  in  Louis- 
ville, he  was  largely  instrumental  in  founding  there  "  The 
Kentucky  School  for  the  Instruction  of  the  Blind." 

Like  his  old  friend  and  correspondent,  John  C.  War- 
ren, Drake  became  early  in  life  an   ardent  temperance 


XIX.  CENTURY.     DRAKE. 


395 


advocate,  and  for  many  years  pushed  the  crusade  in  his 
medical  journal.  Later,  in  1841,  he  organized,  at  the 
Medical  Institute  of  Louisville,  a  Physiological  Temper- 
ance Society  for  the  benefit  of  members  of  the  Medical 
Class. 

More  conspicuous,  however,  than  any  of  these  and  such 
other  activities,  was  his  constant  warm-hearted,  enthu- 
siastic, active  devotion  to  Cincinnati.  Wherever  he  hap- 
pened to  live  in  his  various  wanderings,  that  sentiment 
was  always  with  him.  He  had  come  to  Cincinnati  in  his 
youth,  when  the  place  was  a  straggling  village.  He  was 
the  first  medical  student  there,  and  the  first  Western  med- 
ical graduate.  There  he  had  passed  his  most  successful 
and  most  productive  years.  He  had  grown  up  with  the 
place,  and  there  was  hardly  a  measure  projected  for  its 
advancement,  during  more  than  forty  years,  in  which 
Drake  did  not  take  a  hand. 

This  devotion  met  the  response  it  deserved,  and,  though 
Drake  never  held  public  office  or  took  more  than  a  literary 
part  in  the  political  questions  of  the  day,  there  is  no  doubt 
that  his  fellow-citizens  would  have  given  him  anything  he 
might  have  asked  of  them. 

Of  course,  he  knew  well  all  the  public  characters  of  his 
time.  He  was  intimately  associated  with  Henry  Clay 
during  some  of  the  most  important  years  of  the  latter's 
life;  and  his  friendship  for  Benjamin  Harrison  was  the 
natural  result  of  comradeship  in  many  good  works. 

One  of  his  most  interesting  writings  is  a  series  of  three 
letters  on  the  slavery  question  to  John  C.  Warren  in  1850. 
He  took  much  the  same  ground  that  Lincoln  and  other 
liberal  men  were  then  taking  towards  the  negro.  His  pur- 
pose, however,  was  not  so  much  political  controversy,  as 
it  was  to  point  out  the  actual  facts  of  the  slaves'  condi- 
tion; and  few  men  had  had  larger  opportunities  for  get- 
ting at  those  facts.  He  was  well  aware  of  the  wide-spread 
misapprehension  which  existed  in  the  North  and  East  re- 
garding slavery,  and  his  purpose,  moderately  and  cogently 


396  MEDICINE    IN   AMERICA. 

expressed,  was  to  correct  the  misrepresentations  of  the 
more  fanatical  alx)Htionists. 

His  letters  were  published,  and  for  a  time  attracted 
much  attention ;  but  Mrs.  Stowe's  famous  novel  was  soon 
after  scattered  over  the  land,  and  the  decorous  truths  of 
the  Warren  letters  were  quickly  drowned  in  the  furor 
raised  by  "  Uncle  Tom's  Cabin." 

From  what  we  have  seen  of  his  life,  it  is  evident  that 
he  was  a  very  broad  man,  and  his  catholicity  of  taste  and 
habit  is  not  the  least  interesting  of  his  traits.  In  his  old 
age  he  wrote  a  series  of  charming  "  Reminiscential  Let- 
ters" to  his  children.  The  letters  are  what  the  title 
implies,  and  form  a  valuable  addition  to  our  knowledge 
of  his  times.  Like  most  educated  Americans  of  his 
generation,  and  especially  of  his  profession,  he  was  a 
religious  man,  and  much  of  his  more  intimate  writing  is 
punctuated  by  expressions  of  such  conviction. 

His  pen  was  never  idle,  his  ambition  never  slept,  and  his 
force  was  unabated  to  the  very  last.  In  the  vortex  of 
change  which  has  come  over  the  world's  life  during  the 
past  fifty  years,  it  is  not  altogether  evident  as  yet  what 
place  history  must  assign  to  the  man.  The  wild  West 
which  Drake  knew  in  his  youth  is  now  part  of  the  culti- 
vated East,  and  the  vast  tracts  of  the  Mississippi  basin 
which  he  explored  and  of  which  he  wTOte  have  long  been 
the  commercial  centre  of  the  continent. 

The  books  which  he  produced  —  those  books  which 
Gross  said  were  to  make  him  immortal — are  buried  under 
mountains  of  later  tomes  already  antiquated.  Of  the 
schools  w^hich  he  founded  and  adorned,  some  are  dead, 
and  others  have  risen  to  a  vigor  from  w^hich  he  seems 
very  far  removed ;  but  the  name  of  the  man  himself  has 
survived  changes.  It  is  still  quoted  with  pride  in  the 
Ohio  Valley,  and  one  must  fain  believe  that  of  all  the 
able  pioneers  who  spent  their  lives  in  the  redemption  of 
-American  Medicine  few  are  to  be  placed  higlier  than 
Daniel  Drake. 


CHAPTER    XIV. 

THE    NINETEENTH    CENTURY.       ETHER,    1 846. 

You  may  see  in  the  public  garden  of  Boston  a  curious 
statue, — meaningless  to  him  who  runs, — a  marble  group 
of  two  men  on  a  cluster  of  columns  set  in  a  pool  of  water. 
There  is  a  venerable  person  with  a  patriarchal  beard,  who 
holds  upon  his  knee  the  supine  body  of  a  youth.  Said  a 
child,  gazing  upon  the  figures,  "  That's  Abraham,  and 
he's  going  to  kill  little  Isaac." 

Now,  that  crude  and  inadequate  monument  which  rep- 
resents the  legend  of  the  good  Samaritan  commemorates 
a  great  fact  in  the  world's  history, — notable  especially  to 
Americans,  and  to  surgeons  most  of  all.  If  you  have  the 
curiosity  to  stop  and  read,  you  will  see  these  inscriptions 
on  the  four  faces  of  the  pedestal : 

"  To  commemorate  the  discovery  that  the  inhaling  of 
ether  causes  insensibility  to  pain,  first  proven  to  the  world 
at  the  Massachusetts  General  Hospital  in  Boston,  October, 

A.D.  MDCCCXLVI." 

"  Neither  shall  there  be  any  more  pain." — Revela- 
tion. 

"  This  also  cometh  forth  from  the  Lord  of  Hosts,  which 
is  wonderful  in  counsel  and  excellent  in  working." — 
Isaiah. 

"  In  gratitude  for  the  relief  of  human  suffering  by  the 
inhaling  of  ether,  a  citizen  of  Boston  has  erected  this 
monument,  a.d.  mdccclxvii.    The  gift  of  Thomas  Lee." 

No  other  name  adorns  the  work,  because  in  1867  men 
were  still  questioning  to  whom  the  great  boon  of  an- 
aesthesia rightly  was  due.  The  problem  still  vexes  earnest 
souls  betimes,  and  doubtless  will  continue  so  to  do. 
Dozens  of  controversial  volumes  have  been  written  on 

397 


398  MEDICINE    IX   AMERICA. 

the  matter;  hearts  have  been  grievously  torn  in  the  dis- 
pute; men  have  died  of  it  upbraiding  the  ingratitude  of 
men,  and  the  pity  and  scandal  of  it  all  still  weigh  sadly 
upon  science. 

To  one  of  another  generation  considering  the  records 
and  the  claims,  thankfulness  for  the  gift  is  drowned, 
almost,  in  regret  at  the  quarrel,  the  jealousy,  the  sordid 
motives,  the  lack  of  dignity,  the  malingering,  the  poor 
human  weakness  of  most  of  the  leading  actors  in  the 
scene. 

The  story  has  been  many  times  told,  and  never  told  the 
same.  Let  us  collect  what  we  may  from  it  all ;  set  forth 
the  truth  as  it  seems  to  come  to  us ;  and  gather  from  it 
this  final  consolation,  at  least,  that  the  priceless  boon  was 
brought  to  our  grandfathers,  and  through  the  agency  of 
American  men. 

Two  names  only,  in  any  way  noteworthy,  are  heard  in 
connection  with  the  introduction  of  anaesthesia  in  sur- 
gery. The  one,  that  of  a  shrewd,  ambitious,  commercial, 
New  England  dentist,  W.  T.  G.  Morton,  much  heralded 
in  these  and  former  days;  the  other,  that  of  a  simple, 
straightforward,  modest  country  doctor  in  Georgia, 
Crawford  W.  Long.  There  were  other  claimants  for  the 
gratitude  of  mankind  and  the  dollars  of  their  compatriots, 
— Charles  T.  Jackson,  Wells,  Marcy. 

We  must  remember  that  the  thought  of  painless  sur- 
gery  did  not  burst  upon  the  world  de  novo  in  the  year 
1846,  when  the  first  public  demonstration  of  ether  an- 
aesthesia was  given.  Running  through  all  medical  his- 
tory, there  is  a  constant  reference  to  the  abolishing  of 
pain,  and  even  among  the  ancients  many  fairly  successful 
attempts  were  made  in  that  direction. 

Poppy,  henbane,  mandragora,  and  hemp  were  used  to 
deaden  the  pain  of  execution  and  surgery  in  remote  an- 
tiquity. Herodotus  tells  us  how  the  Scythians  used  a 
vapor  of  hempseed  to  cause  drunkenness.    That  far-away 


ETHER. 


399 


Chinaman,  Hoa-tho,  gave  hashisch  in  a.d.  220,  and  per- 
formed painless  amputations.  Pliny,  in  the  first  century 
of  our  era,  wrote  that  mandragora  is  "  drunk  before  cut- 
tings and  puncturings,  lest  pain  be  felt."  Dioscorides, 
Dodonjeus.  and  Apuleius  bear  similar  testimony.  In  the 
middle  ages  and  later,  Theodoric  and  Canappe  described 
the  anaesthesia  produced  by  the  Spongia  somnifera  boiled 
dry  in  strong  narcotics,  and  moistened  for  inhalation. 

In  1828  Girardin  described  before  the  Academy  of 
Medicine  a  surgical  anaesthesia  induced  by  inhaled  gas. 
Countless  surgeons  made  their  patients  drunk  before  oper- 
ating. Napoleon's  Larrey  found  that  intense  cold  pro- 
duced partial  insensibility;  and  mesmerism  and  hyp- 
notism had  their  advocates. 

In  1784  the  Englishman  James  Moore  diminished  pain 
by  clamping  nerve-trunks  running  to  the  affected  parts; 
and,  most  interesting  of  all,  Humphry  Davy,  then  a  young 
practitioner  at  Clifton,  England,  discovered  the  intoxi- 
cating properties  of  nitrous  oxide  gas  in  1799. 

There  are  numerous  other  such  experiences  given  in 
our  literature.  For  instance,  in  181 8  Faraday  wrote  to 
the  Journal  of  Science  and  the  Arts,  "  When  the  vapor  of 
ether  mixed  with  common  air  is  inhaled,  it  produces 
effects  very  similar  to  those  of  nitrous  oxide.  It  is  neces- 
sary to  use  caution  in  making  experiments  of  this  kind. 
By  imprudent  inspiration  of  ether  a  gentleman  was 
thrown  into  a  very  lethargic  state,  which  continued,  with 
occasional  periods  of  intermission,  for  more  than  thirty 
(  !)  hours,  and  a  great  depression  of  spirits;  for  many 
days  the  pulse  was  so  much  lowered  that  considerable 
fears  were  entertained  for  his  life." 

The  amazing  thing  to  us,  reviewing  such  events,  is  that 
so  many  accidental  discoveries  and  ascertained  facts, 
through  all  previous  time,  led  to  no  systematic  study  of 
the  subject  or  well-sustained  attempt  to  set  an  end  to 
pain.     Indeed,  for  many  years  before  the  time  of  Long, 


400  MEDICINE    IN    AMERICA. 

Morton,  and  Wells,  the  scientific  world  knew  something 
of  the  anaesthetic  properties  of  "  laughing  gas"  and  ether, 
and  made  no  use  of  them. 

What  was  it,  then,  that  caused  the  inertia?  Surgical 
pain  was  real  enough ;  there  was  no  disguising  it.  The 
terror  of  operations  was  a  very  hell,  even  in  anticipation ; 
the  fact  itself  no  man  has  found  words  to  describe.  The 
shadow  of  it  has  lengthened  even  to  our  own  day.  Sur- 
geons as  well  as  patients  dreaded  the  knife.  Operations 
were  very  rare  and  a  last  resort.  Two  years  before  1846 
Robert  Liston  told  his  class  that  operating  "  is  regarded 
as  an  inferior  part  of  our  professional  duties ;  and,  truly, 
it  is  so.  The  field  of  operative  surgery,  though  happily 
narrowed,  is  still  extensive." 

Surgeons  are  surely  the  most  merciful  of  men,  yet  we 
know  that  Celsus  commends  to  them  "  pitilessness"  as  an 
essential  trait.  The  lives  of  all  great  surgeons  before  the 
days  of  ether  tell  continually  their  dread  of  operating  and 
their  resort  to  all  other  conceivable  measures.  Ashhurst, 
in  his  delightful  little  essay  on  "  Surgery  before  the  Days 
of  Anaesthesia,"  ^  relates  how  Sir  James  Simpson,  shortly 
after  beginning  the  study  of  medicine,  was  so  affected 
by  "  seeing  the  terrible  agony  of  a  poor  Highland  woman 
under  amputation  of  the  breast"  that  he  resolved  to  aban- 
don a  medical  career  and  seek  other  occupation. 

And  looking  for  further  record  of  those  days  of  agony, 
Ashhurst  tells  of  the  most  striking  picture  known  to  him, 
showing  how  an  intelligent  patient  looked  upon  a  surgical 
operation.  It  is  in  a  letter  written  to  Sir  James  Simpson 
by  a  friend,  himself  a  member  of  the  medical  profession, 
who  had  had  a  limb  amputated  before  the  ether  days :  "  I 
at  once  agreed  to  submit  to  the  operation,  but  asked  a  week 
to  prepare  for  it ;   not  with  the  slightest  expectation  that 


'  Read  at  the  Semicentennial  of  Anaesthesia,  Massachusetts  General 
Hospital,  Boston,  October  16,  1896. 


ETHER.  401 

the  disease  would  take  a  favorable  turn  in  the  interval 
or  that  the  anticipated  horrors  of  the  operation  would  be- 
come less  appalling  by  reflection  upon  them,  but  simply 
because  it  was  so  probable  that  the  operation  would  be 
followed  by  a  fatal  issue  that  I  wished  to  prepare  for 
death  and  what  lies  beyond  it  whilst  my  faculties  were 
clear  and  my  emotions  comparatively  undisturbed.  .  .  . 
The  morning  of  the  operation  arrived.  The  operation 
was  a  more  tedious  one  than  some  which  involve  much 
greater  mutilation.  It  involved  cruel  cutting  through 
inflamed  and  morbidly  sensitive  parts,  and  could  not  be 
despatched  by  a  few  strokes  of  the  knife.  ...  Of  the 
agony  it  occasioned  I  will  say  nothing.  Suffering  as  great 
as  I  underwent  cannot  be  expressed  in  words,  and  thus, 
fortunately,  cannot  be  recalled.  The  particular  pangs  are 
now  forgotten;  but  the  blank  whirlwind  of  emotion,  the 
horror  of  great  darkness,  and  the  sense  of  desertion  by 
God  and  man,  bordering  close  upon  despair,  which  swept 
through  my  mind  and  overwhelmed  my  heart,  I  can  never 
forget,  however  gladly  I  would  do  so.  Only  the  wish 
to  save  others  some  of  my  sufferings  makes  me  deliber- 
ately recall  and  confess  the  anguish  and  humiliation  of 
such  a  personal  experience ;  nor  can  I  find  language  more 
sober  and  familiar  than  that  I  have  used  to  express  feel- 
ings which,  happily  for  us  all,  are  too  rare  as  matters  of 
general  experience  to  have  shaped  into  household  words. 
During  the  operation,  in  spite  of  the  pain,  my  senses  were 
preternaturally  acute.  ...  I  watched  all  that  the  surgeon 
did  with  a  fascinated  intensity.  I  still  recall  with  unwel- 
come vividness  the  spreading  out  of  the  instruments,  the 
twisting  of  the  tourniquet,  the  first  incision,  the  fingering 
of  the  sawed  bone,  the  sponge  pressed  on  the  flap,  the 
tying  of  the  blood-vessels,  the  stitching  of  the  skin,  and 
the  bloody  dismembered  limb  lying  on  the  floor.  These 
are  not  pleasant  remembrances.  For  a  long  time  they 
haunted  me,  and,  though  they  cannot  bring  back  the  suf- 

26 


402  MEDICINE    IN    AMERICA. 

fering,  they  can  occasion  a  suffering  of  their  own,  and  be 
the  cause  of  a  disquiet  which  favors  neither  mental  nor 
bodily  health." 

Such  and  such  like  were  the  conditions  of  surgery  and 
the  search  after  relief  until  near  the  middle  of  the  nine- 
teenth century ;  but  looking  back  upon  it  all  now,  one  sees 
that  the  end  of  those  many  generations  of  horror  was 
drawing  near.  Just  as  the  eighteenth  century  witnessed 
the  political  emancipation  of  the  Western  peoples,  so  the 
nineteenth  century,  with  its  intellectual  emancipation  and 
marvellous  altruism,  was  to  find  an  end  for  pain.  Towards 
the  middle  of  the  century  men  were  developing  a  new 
medicine,  and  anaesthesia  was  in  sight. 

We  have  heard  that  certain  of  the  properties  of  ether 
had  been  familiar  to  chemists  for  many  years.  Nitrous 
oxide  and  ether  were  known  to  be  stimulating  and  sooth- 
ing. Their  inhalation  intoxicated  and  threw  one  into  a 
sleep.  It  had  been  casually  observed  that  blows  and  falls 
caused  no  pain  when  one  was  under  the  influence  of  the 
drugs.  Among  students  and  amateurs  in  science  "  ether 
frolics"  were  common  during  the  second  quarter  of  the 
century.  Through  such  frolics  and  half-knowledge  came 
the  suggestion  to  one  of  our  two  ether  claimants.  Long,  of 
Georgia, — knowledge  not  sought  nor  altogether  obvious 
at  the  time.  B}'-  his  rival,  Morton,  of  Boston,  a  man  of 
another  temper,  diligently  seeking  the  relief  of  pain,  ether 
was  truly  discovered  as  by  one  after  long  search ;  and  the 
manner  of  their  findings  was  on  this  wise : 

Crawford  W.  Long  was  a  young  doctor  living  in  the 
village  of  Jefiferson,  Jackson  County,  Georgia,  in  the  year 
1842.  He  was  twenty-seven  years  old,  born  in  Daniels- 
ville,  Georgia,  on  November  i,  181 5.  He  had  been  grad- 
uated M.D.  from  the  University  of  Pennsylvania  in  1839, 
and  had  entered  upon  practice  in  Jefferson  in  1841. 

About  that  time  the  custom  of  "  ether  frolics"  was  com- 
mon in  the  region,  having  been  brought  there  by  a  wan- 


ETHER.  403 

dering"  lecturer.  The  story  is  that  there  was  hardly  a 
gathering  of  young  people  which  did  not  end  with  an 
"  ether  frolic;"  the  girls  and  boys  finishing  the  evening 
by  inhaling  ether, — some  would  laugh,  some  cry,  some 
fight,  and  some  dance. 

Now,  on  one  occasion,  they  had  exhausted  their  own 
number,  and,  looking  round  for  a  further  victim,  caught 
a  negro  boy  peeping  through  the  door.  They  haled 
him  in,  and,  while  he  fought  and  struggled,  etherized  him 
into  insensibility.  Then,  when  he  lay  quiet  and  uncon- 
scious, breathing  heavily,  they  fell  into  a  panic  fright,  and 
sent  for  Dr.  Long.  He  soon  reached  the  house  where  the 
boy  was  still  unconscious,  and  his  chief  tormentor,  the 
hero  of  the  ether  cone,  was  planning  to  flee  the  country. 
As  we  should  now  expect,  the  victim  soon  came  to  him- 
self, none  the  worse  for  his  mishandling. 

In  the  following  year,  the  lad  who  had  looked  upon 
himself  for  a  short  time  as  a  murderer  betook  himself 
to  the  study  of  medicine,  and  entered  Long's  office  as  a 
student. 

The  two  men — master  and  pupil — had  not  forgotten 
their  experience  with  the  negro  boy,  and,  talking  over  the 
effects  of  ether,  determined  to  try  it  in  a  suitable  surgical 
case.  Their  first  chance  came  on  March  30,  1842,  when 
a  patient  applied  to  Long  for  the  removal  of  a  small  cystic 
tumor  of  the  jaw.  The  operation  was  painless,  and  the 
patient,  James  M.  Venables,  was  delighted  with  the  per- 
formance. The  ether  was  given  on  a  folded  towel,  but 
the  ansesthesia,  from  our  present  view-point,  appears  to 
have  been  incomplete. 

Long  does  not  seem  to  have  pushed  his  researches  far 
enough  to  determine  the  limit  of  safety  of  the  drug  or  to 
have  become  convinced  of  its  certainty.  Many  writers 
state  that  he  gave  up  its  use  after  a  short  trial,  though  his 
own  brief  and  interesting  essay  on  the  subject  does  not 
bear  out  this  assertion. 


404 


MEDICINE    IN    AMERICA. 


He  failed,  however,  to  appreciate  the  enormous  impor- 
tance of  his  discovery,  and  he  did  nothing  for  many  years 
to  inform  a  suffering  world.  In  1852,  however,  he  read 
a  paper  on  ether  before  the  Georgia  Medical  Society,  and 
in  the  Southern  Medical  and  Surgical  Journal  of  Decem- 
ber, 1849,  were  quoted  certificates  of  patients  regarding 
his  work.  But  he  was  a  modest  man,  and  never  persist- 
ently pushed  his  claims ;  though  they  were  admitted  pub- 
licly,^ in  1 86 1,  by  Charles  T.  Jackson,  of  whom  we  shall 
hear  presently.  For  many  years  all  this  was  forgotten, 
until  in  1877  J.  Marion  Sims  again  told  the  story  of  the 
man. 

How  justly  Long  might  claim  from  posterity  the  credit 
of  having  discovered  ether  anaesthesia  it  is  idle  now  to 
speculate ;  and  whether,  in  the  absence  of  a  more  energetic 
exploiter,  he  might  in  time  have  enlightened  the  world. 
Certain  it  is  that,  even  with  his  four  years'  start  of  Mor- 
ton, he  was  unheard  of  beyond  his  own  neighborhood 
until  many  years  after  the  latter's  famous  demonstration. 

While  Long  was  still  experimenting  with  ether  in  a 
desultory  way  down  in  Georgia,  an  energetic  set  of  men 
were  finding  other  means  of  inducing  anesthesia  in 
the  town  of  Hartford,  Connecticut.  Their  vehicle  was 
nitrous  oxide ;  and  it  was  a  wandering  lecturer,  G.  S.  Col- 
ton,  who  supplied  the  clew.  In  December,  1844,  he  gave 
a  public  exhibition  of  the  gas,  and  a  young  dentist.  Hor- 
ace Wells,  who  was  in  the  audience,  was  so  impressed  with 
the  possibilities  of  the  new  medium  that  he  had  Colton 
administer  it  to  him  the  next  day,  when  a  brother  dentist 
extracted  one  of  his  teeth.  As  Colton  tells  the  story, 
Wells  exclaimed,  on  coming  to  himself,  "  It  is  the  greatest 
discovery  ever  made :  I  did  not  feel  it  so  much  as  the  prick 
of  a  pin." 

Wells  began  using  the  gas  as  an  anaesthetic,  and  con- 


Boston  Medical  and  Surgical  Journal,  April  11,  1861. 


ETHER.  405 

tinued  to  do  so  for  many  months.  Looking  about  for 
some  other  similar  drug,  his  attention  was  called  to  sul- 
phuric ether ;  and  one  of  his  associates,  a  physician,  E.  E. 
Marcy,  used  the  latter,  at  Wells's  suggestion,  in  removing 
a  wen  of  the  scalp. 

The  use  of  ether  was  not  persisted  in  then,  however, 
as  it  was  thought  dangerous;  but  it  was  not  abandoned 
until  Wells  had  suggested  its  possibilities  to  Valentine 
Mott,  who  referred  to  it  in  an  article  in  the  Boston  Medi- 
cal and  Surgical  Journal,  June  15,  1845, — probably  the 
earliest  American  publication  on  the  subject. 

Soon  after  nitrous  oxide  had  come  into  use  at  Hartford, 
Wells  went  on  to  Boston  and  secured  an  introduction  to 
J.  C.  Warren,  whom  he  persuaded  to  allow  a  demonstra- 
tion of  its  properties  in  a  dental  case  at  the  Massachusetts 
General  Hospital. 

Through  some  inadvertence,  the  patient  did  not  receive 
enough  of  the  gas,  and  howled  with  pain.  Wells  seems 
to  have  been  a  modest  young  fellow  of  unusual  sensibility, 
so  that  the  jeers  of  the  students  and  the  ridicule  of  their 
seniors  discouraged  him  utterly  for  the  time  being.  Pro- 
foundly depressed,  he  returned  to  Hartford,  and  soon 
afterwards  departed  for  Europe  on  other  business. 

So  much  for  preliminaries. 

Now  we  come  to  the  leading  figure  in  this  ether  drama, 
William  T.  G.  Morton.  The  personality  of  the  man  has 
been  so  befogged  by  eulogy  on  the  one  hand  and  by  slan- 
der on  the  other,  that  it  is  not  altogether  easy  to  come 
to  a  clear  understanding  of  him.  His  beginnings  were 
commonplace  enough. 

The  son  of  a  country  store-keeper  and  small  farmer, 
he  was  born  at  Charlton,  Worcester  County,  in  Massachu- 
setts, on  August  19,  1 8 19.  After  a  brief  common  school 
training  he  became  a  clerk  in  his  father's  store.  He  was 
a  magnetic,  virile,  persuasive  man.  From  the  outset  he 
seems  to  have  been  pushing  and  ambitious  to  better  him- 


4o6  MEDICINE    IN    AMERICA. 

self,  and  would  have  studied  medicine  had  his  father  been 
able  to  gratify  him.  When  twenty-one  years  old,  how- 
ever, he  was  able  to  go  to  the  Dental  College  of  Baltimore, 
and,  having  a  natural  aptitude  for  mechanics,  he  gradu- 
ated creditably  in  course.  In  1842  he  settled  in  Boston, 
and  there  formed  a  partnership  with  Horace  Wells  for  the 
practice  of  dentistry.  After  an  unprofitable  year  the  two 
separated, — Wells  going  to  Hartford  and  Morton  remain- 
ing in  Boston. 

Before  long  his  practice  increased  so  satisfactorily  that 
he  found  himself  able  to  realize  his  early  ambition,  and 
began  the  study  of  medicine  at  the  Harvard  Medical 
School  while  continuing  his  dental  work.  He  was  never 
graduated  from  the  Harvard  School,  however,  as  his  dem- 
onstration of  ansesthe'sia  quickly  followed  to  interfere  with 
and  break  up  his  medical  career. 

As  we  have  followed  the  development  of  medicine  in 
this  country  and  watched  the  struggle  of  our  rare  early 
men  of  science  to  elevate  their  calling,  we  have  seen  how 
their  greatest  obstacle  was  the  commercial  spirit  which 
possessed  the  mass  of  the  profession.  Men  entered  upon 
a  medical  career  for  the  sake  of  a  living  and  money- 
getting.  The  art  of  medicine  was  their  highest  ambition ; 
of  the  science  they  knew  little,  and  for  it  they  cared  less. 
To  this  class  in  the  community  Morton  belonged. 

He  was  a  shrewd  fellow,  with  an  eye  to  the  main 
chance;  and  he  early  perceived  that  the  greatest  disad- 
vantage under  which  the  dentist  labored  was  the  inevi- 
table pain  which  he  must  constantly  cause  his  patients. 

In  those  days  the  art  of  filling  and  preserving  teeth  was 
very  crude  indeed.  As  compared  with  the  admirable  work 
of  our  own  time,  little  was  done,  and  a  large  part  of  the 
dentist's  occupation  consisted  in  extracting  teeth,  treating 
the  gums,  and  fitting  plates.  Owing,  also,  to  the  common 
dread  of  having  teeth  extracted,  patients  preferred  having 
the  plates  soldered  to  the  old  fangs.     To  fasten  the  arti- 


ETHER.  407 

ficial  teeth  upon  the  plate  necessitated  the  use  of  a  gold 
solder  softer  than  the  metal  plate,  as  a  heat  sufficient  to 
dissolve  a  proper  solder  would  have  melted  the  plate  be- 
neath. This  method  set  up  a  reaction  between  the  metals 
in  the  solder  and  the  gold  plate,  so  that  the  solder  changed 
color,  and  there  resulted  a  black  line  about  the  base  of  each 
tooth.  Now,  Morton,  in  order  to  correct  this  offence, 
found  a  way  to  use  a  solder  of  the  same  material  as  the 
plate;  but  his  further  plan  involved  the  removal  of  the 
old  fangs, — a  painful  process,  and  to  the  relief  of  this  he 
soon  turned  his  attention. 

Doubtless  all  these  facts  are  dreary  enough  in  the  re- 
cital, but  when  we  approach  a  great  revolution  in  human 
life,  it  is  well  to  inspect  the  causes,  however  trivial.  So 
the  ingenious  dentist  tried  various  methods  to  relieve 
pain.  Opium  and  alcohol,  commonly  employed  in  sur- 
gery, he  used,  of  course,  but  always  with  a  feeling  that 
they  were  clumsy  and  inefficient. 

In  one  case  he  tried  local  applications  of  sulphuric  ether 
and  found  that  it  benumbed  the  parts. 

So  far  he  had  reached ;  and  it  is  just  her^  that  we  come 
to  the  burning  question  of  precedence  and  the  origin  of 
the  bitter  controversy  which  rent  the  profession  for  more 
than  a  generation. 

Where  did  Morton  get  his  idea  of  the  use  of  ether? 
Who  first  suggested  it?  Did  he  steal  it  from  some  one 
else?  Did  he  come  to  his  success  through  the  teaching 
of  another  man,  or  did  he  himself  evolve  the  procedure 
which  we  believe  will  number  him  with  the  immortals? 
It  is  a  very  real  conundrum, — futile  to  most  of  us  to-day, 
whatever  it  may  have  been  to  those  sorely  tried  men  of  an 
earlier  time.  Such  as  it  is,  however,  history  demands  that 
we  search  patiently  in  its  muddy  depths. 

In  1844,  the  third  year  of  Morton's  practice  in  Boston, 
while  he  was  preparing  to  matriculate  at  the  Medical 
School,  he  had  entered  his  name  in  the  office  of  Dr. 


4o8  MEDICINE    IN    AMERICA. 

Charles  T.  Jackson  as  a  student  of  medicine,  and  with  his 
young  wife,  whom  he  had  recently  married,  he  spent  the 
summer  months  of  the  same  year  as  a  member  of  that 
gentleman's  family. 

Jackson  was  a  man  who  needed  no  introduction  to  a 
Boston  audience  in  his  day.  He  was  a  scientist  of  national 
reputation  and  a  distinguished  chemist.  To  the  popular 
mind  he  was  a  veritable  wizard, — a  discoverer  of  all  sorts 
of  things,  a  museum  of  scientific  information.  He  had 
an  unusual  knowledge  of  electricity,  among  other  things, 
and  raised  a  doubt  in  many  minds  whether  the  discovery 
of  the  electric  telegraph  should  not  be  credited  to  him 
rather  than  to  Morse. 

Withal,  Jackson  was  a  companionable,  agreeable  per- 
son, much  sought  after  by  students  and  others,  popular 
and  respected. 

Morton,  through  his  brief  association  with  Wells  and 
the  latter's  subsequent  experiments  with  nitrous  oxide, 
naturally  became  somewhat  familiar  with  that  drug  as  an 
anaesthetic  agent,  but  came  early  to  feel  that  it  did  not 
meet  all  requirements. 

In  July,  1844,  a  Miss  Parrott,  of  Gloucester,  Massachu- 
setts, called  on  Morton  to  have  a  tooth  filled ;  and,  as  she 
was  extremely  sensitive  to  pain,  he  tried  the  experiment 
of  applying  chloric  ether  locally  to  the  gums.  This  he  did 
on  the  suggestion  of  Jackson,  who  said  he  had  used  it  as 
toothache  drops  when  he  practised  medicine.  In  Miss 
Parrott's  case  the  application  of  the  drug  seemed  to  be  of 
service. 

These  two  remedies  for  pain, — nitrous  oxide  and  ether, 
— Morton  kept  in  mind,  and  long  debated  their  further 
use.  Fortunately,  for  the  solution  of  his  problem,  there 
came  into  his  office  in  the  spring  of  1846,  as  dental  stu- 
dent, Thomas  R.  Spear,  Jr.  Spear  was  immediately 
roused  by  the  anaesthesia  talk,  and  told  his  instructor 
how,  frequently,  as  a  school-boy  at  the  Lexington  Acad- 


ETHER.  409 

emy,  he  had  amused  and  exhilarated  himself  by  the  in- 
halation of  ether. 

This  seems  to  have  been  the  final  thing  needed  to  rouse 
Morton's  enthusiasm  and  stimulate  his  curiosity.  He 
began  etherizing  animals,  fish,  dogs,  and  such,  and  be- 
came so  convinced  of  the  value  of  the  drug  that  he  waited 
only  for  a  human  subject.  He  went  so  far  in  his  earnest- 
ness that  in  June  of  that  year  he  secured  the  services  of 
Grenville  G.  Hayden  to  look  after  his  office  practice,  so 
that  he  might  devote  more  time  to  his  researches ;  and  he 
explained  his  purposes  to  his  attorney,  Richard  H.  Dana, 
Jr.,  when  that  gentleman  drew  the  partnership  contract 
for  him  and  Hayden. 

This  date,  in  the  early  part  of  that  eventful  summer, 
we  are  asked  to  note,  as  it  bears  upon  the  wrangle  which 
ensued. 

During  the  following  months  Morton  pursued  his  in- 
quiries in  a  quiet  and  secretive  fashion,  always  fearful 
that  some  other  investigator  would  anticipate  him  and 
snatch  his  laurels.  He  bought  ether  of  Joseph  Burnett, 
a  well-known  dealer  in  good  drugs;  he  discussed  the 
nature  of  ether  with  Theodore  Metcalf,  another  reliable 
apothecary;  he  investigated  inhaling  apparatus  with 
Joseph  M.  Wightman,  a  maker  of  chemical  supplies,  and, 
finally,  on  September  30,  he  betook  himself  again  to  his 
old  preceptor,  Jackson,  to  learn  from  him  what  further 
he  might  know  of  the  properties  of  ether. 

In  this  interview  with  Jackson,  Morton  concealed  en- 
tirely his  purposes,  and  presented  himself  as  a  novice 
seeking  information. 

His  story  was  that  he  had  a  hysterical  patient  who 
needed  to  have  teeth  out.  He  asked  Jackson  to  lend  him 
some  sort  of  inhaling  bag,  which  he  would  use  with  pure 
air  only,  convincing  the  patient  of  anaesthesia  through 
mental  impression.  Jackson  laughed,  and  asked  him  why 
he  did  not  try  mesmerism  or  ether,  which  was  perfectly 


4IO  MEDICINE   IN    AMERICA. 

harmless.  Said  Morton,  "  And  what  is  ether?"  That  is 
the  key  to  Morton's  attitude.  One  tries  vainly  to  fancy 
Jenner  asking,  "  What  is  cowpox?"  or  Rontgen  puzzled 
by  the  mention  of  Crookes's  tubes. 

At  any  rate,  Jackson  was  deceived.  He  explained  to 
Morton  the  nature  of  ether  and  how  to  inhale  it,  illus- 
trating with  a  dry,  folded  towel.  "  It  won't  do  any 
harm,"  he  said.  *'  College-  and  school-boys  often  amuse 
themselves  by  breathing  it,  and  I  have  tried  it  myself." 

This  was  the  final  word  Morton  wanted.  It  was  what 
he  really  was  after.  He  went  home  and  etherized  himself 
into  unconsciousness,  reviving  after  a  few  minutes  with- 
out ill  effects.  It  was  the  test,  like  that  on  Long's  negro 
boy  in  Georgia,  and  he  was  ready  now  to  try  it  on  a 
patient. 

Almost  at  once  the  patient  presented  himself.  That 
very  evening  a  man  by  the  name  of  Frost,  a  musician,  and 
a  stout,  wholesome  person,  applied  to  him  for  the  extrac- 
tion of  a  painful  tooth.  He  was  frightened,  and  asked  if 
mesmerism  might  not  be  tried.  Morton  told  him  that  he 
had  something  better  than  mesmerism,  and  the  man  read- 
ily consented  to  its  use.  Promptly  the  patient  seated  him- 
self. Morton  held  to  his  nostrils  a  towel  saturated  with 
ether ;  the  patient  became  unconscious, — in  what  we  now 
should  call  a  state  of  primary  anesthesia.  A  deeply  ad- 
herent bicuspid  tooth  was  extracted,  and  the  man  quickly 
regained  consciousness.  He  asked  the  street  number  of 
the  house;  he  said  he  had  never  been  so  happy  in  his 
life,  vowed  he  felt  no  pain,  and  joyfully  gave  Morton  a 
certificate  ^  of  his  experience. 


^  This  is  to  certify  that  I  applied  to  Dr.  Morton  this  evening  at 
eight  o'clock,  suffering  under  the  most  violent  toothache ;  that  Dr. 
Morton  took  out  his  handkerchief,  saturated  it  with  a  preparation 
of  his,  from  which  I  breathed  about  half  a  minute,  and  then  was 
lost  in  sleep.  In  an  instant  more  I  awoke  and  saw  my  tooth  lying 
on  the  floor.     I  did  not  experience  the  slightest  pain  whatever.     I 


ETHER. 


411 


Of  course,  the  performance  was  promptly  advertised 
in  the  newspapers.  A.  G.  Tenney,  a  reporter  for  the  Bos- 
ton Journal,  had  been  a  witness  to  the  dentist's  feat  and 
recorded  his  observations. 

The  next  day  Morton  went  back  to  Jackson  for  more 
suggestions.  He  told  him  of  his  success  with  Frost,  and 
asked  him  for  a  certified  statement  that  ether  might  be 
inhaled  with  safety.  Very  naturally,  Jackson,  with  his 
limited  knowledge,  refused  to  put  his  name  to  any  such 
document.  Furthermore,  he  told  Morton  that  one  suc- 
cessful etherization  in  private  for  a  trivial  operation  would 
not  convince  the  public  of  the  value  of  the  drug  as  an 
anaesthetic.  He  advised  him  to  arrange  for  a  public 
demonstration  under  the  observation  of  competent  wit- 
nesses. 

Poor  Wells's  experience  with  nitrous  oxide,  of  course, 
suggested  the  Massachusetts  General  Hospital,  then  the 
only  hospital  in  Boston.  It  was  the  obvious  place  for  the 
ether  exhibition ;  but  Morton  dreaded  premature  publicity. 
— not,  as  in  the  case  of  Koch  with  tuberculin,  because  his 
researches  were  as  yet  incomplete,  but  because  he  feared 
his  audience  would  recognize  the  characteristic  smell  of 
ether.  He  accepted  Jackson's  advice  only  after  being 
shown  how  to  disguise  the  odor  of  ether  with  eau  de  mille 
fleurs,  the  oil  of  Neroli,  or  some  essence  of  that  sort.  Of 
course,  Morton  recognized  the  value  of  Jackson's  urging, 
and  a  few  days  later  proceeded  to  put  his  advice  into 
effect. 

John  Collins  Warren  was  still  active  in  the  affairs  of  the 


remained  twenty  minutes  in  his  office  afterwards  and  felt  no  un- 
pleasant effects  from  the  operation. — Eben  H.  Frost. 
Boston,  42  Prince  Street,  September  30,  1846. 

We  witnessed  the  above  operation,  and  the  statement  is  in  all 
respects  correct.  And,  what  is  more,  the  man  asked  where  his  tooth 
was,  or  if  it  was  out. 

A.  G.  Tenney,  Journal  OfUce. 
G.  G.  Hayden,  Surgeon  Dentist. 


412  AIEDICINE    IN    AMERICA. 

hospital,  and,  although  now  an  old  man,  was  distinctly 
the  most  conspicuous  surgeon  in  New  England,  if  not 
in  America.  To  \\'arren,  then,  Morton  betook  himself 
and  made  known  his  wishes.  The  two  men  had  had  a 
slight  acquaintance  for  a  year  or  two,  as  was  inevitable 
in  so  small  a  town  as  Boston  then  was ;  and  AA'arren  knew 
the  young  dentist  for  an  ingenious  and  energetic  practi- 
tioner of  excellent  standing. 

The  elder  man,  through  a  lifelong  experience  of  mis- 
placed enthusiasms  and  scientific  bubbles,  was  naturally 
sceptical  of  ]\Iorton's  claims;  but  he  listened  to  him,  was 
impressed  by  his  story,  and  promised  to  give  him  a  chance 
to  use  his  new  remedy  on  the  first  suitable  surgical  patient 
that  presented  himself  at  the  hospital. 

Hodges,'*  the  narrator  of  these  events,  remarks  that  at 
no  time  in  its  histon,-  had  the  Massachusetts  General  Hos- 
pital been  so  prosperous  as  at  the  period  now  reached. 
New  wings  had  recently  been  added,  nearly  trebling  the 
capacity  of  the  building,  and  the  Stafif  had  been  enlarged. 
The  visiting  surgeons  in  1846  were  John  Collins  \\^arren, 
George  Hayward,  Solomon  D.  Townsend,  Henry  J.  Bige- 
low,  Jonathan  ]\Iason  Warren,  and  Samuel  Parkman ;  to 
all  these  it  fell  to  witness  Morton's  first  ether  demon- 
stration. 

On  October  13,  1846,  a  young  man  of  twenty,  Gilbert 
Abbott,  a  printer,  tall  and  feeble,  with  a  tubercular  he- 
redity, was  brought  to  the  amphitheatre  of  the  hospital  for 
operation  on  a  "  congenital  but  superficial,  vascular  tumor, 
just  below  the  jaw,  on  the  left  side  of  the  neck."  He  was 
under  the  care  of  J.  C.  Warren,  and  that  surgeon,  as  he 
was  about  to  begin  the  operation,  was  reminded  of  his 
recent  conversation  with  Morton.  Here  was  a  suitable 
case  for  the  experiment  in  painless  surgery.    He  explained 


*The  Introduction  of  Surgical  Anaesthesia,  by  Richard  M.  Hodges, 
M.D.,  Boston,  1891. 


ETHER.  413 

the  situation  to  the  patient,  and  the  latter  gladly  consented 
to  submit  himself  to  the  novel  treatment.  The  operation 
was  postponed  three  days,  to  Friday,  October  16,  and 
Morton  agreed  to  be  present  with  his  mixture. 

Meantime  there  was  raised  the  question  of  method. 
Jackson,  who  was  again  consulted,  suggested  a  form  of 
inhaler  consisting  of  a  large  glass  flask,  with  a  bent  glass 
tube  three  feet  long.  This  was  modified  by  Wightman, 
who  introduced  a  funnel  face-piece,  and  valves  to  allow 
of  the  entrance  of  air. 

At  the  appointed  hour  on  the  momentous  i6th  of  Octo- 
ber, Warren  and  his  patient  were  ready  in  the  hospital 
amphitheatre.  The  members  of  the  Surgical  Staff  at- 
tended also,  and  the  seats  were  filled  by  the  class  from 
the  Medical  School.  Nothing  was  lacking  to  lend  dig- 
nity and  publicity  to  the  enterprise  but  the  presence  of 
Morton  himself,  the  central  figure.  He  was  unaccount- 
ably late. 

Warren,  who  was  the  soul  of  punctuality  and  not  accus- 
tomed to  wait  on  the  convenience  of  others,  appears  to 
have  lost  patience.  After  a  delay  of  a  quarter  of  an  hour, 
he  turned  to  his  audience  and  said,  "  As  Dr.  Morton  has 
not  arrived,  I  presume  he  is  otherwise  engaged."  The 
scepticism  and  the  sneer  were  very  obvious.  He  sat  down 
by  his  disappointed  patient,  and  was  about  to  make  the 
first  incision,  when  Dr.  Morton  rushed  into  the  room.  He 
had  been  delayed  by  repairs  upon  his  inhaler. 

As  yet  the  nature  of  the  drug  to  be  used  was  unknown 
even  to  Warren.  One  of  Morton's  friends  had  advised 
him  to  disclose  his  secret  to  the  surgeon;  but  he  did  not 
do  so,  and  is  said  to  have  stated  later  that  he  was  given 
no  time  for  such  confidences.  The  consequence  was  that 
Warren  did  his  work  in  ignorance  of  the  agent  at  his 
command,  and  the  responsibility  for  its  employment  rested 
mainly  upon  Morton. 

Years  afterwards  Jacob  Bigelow  praised  the  courage 


414  MEDICIXE    IX    A^IERICA. 

of  the  surgeon  who  encountered  the  unknown  risks  of  an 
etherization.  That  is  as  may  be.  The  fact  remains  that 
at  the  time  ^\'arren  did  his  work  he  was  as  much  in  the 
dark  as  any  of  the  curious  spectators. 

On  coming  to  the  operating  table,  Morton  proceeded 
with  his  novel  duties. 

"  Are  you  afraid  ?"  he  said  to  the  patient.  "  No,"  was 
the  reply.  "  I  feel  confident,  and  will  do  precisely  as  you 
tell  me."  Pointing  to  Frost,  who  had  accompanied  him, 
Morton  said,  "  There  is  a  man  who  has  breathed  it,  and 
can  testify  to  its  success."  Hodges  says  the  spectators 
looked  on  incredulously,  especially  as  the  patient  at  first 
became  exhilarated ;  but  suddenly,  when  his  unconscious- 
ness was  evident,  there  was  a  start  of  surprise. 

Morton  turned  to  Warren,  and  told  him  that  his  patient 
was  ready.  The  surgeon  immediately  set  to  work.  The 
operation  was  short  and  easy,  and  in  the  hands  of  the  ex- 
pert dissector  was  completed  in  five  minutes.  The  patient 
lay  quiet  at  first  and  gave  no  sign  of  sensation.  The 
audience  looked  on  in  amazed  silence.  Towards  the  end 
the  man  began  "  to  move  his  limbs  and  to  utter  ex- 
traordinary expressions,  and  these  movements  seemed  to 
indicate  the  existence  of  pain;  but  after  he  had  recov- 
ered his  faculties,  he  said  he  had  experienced  none,  but 
only  a  sensation  like  that  of  scraping  the  part  with  a  blunt 
instrument."  ^ 

It  is  obvious  now.  of  course,  that  the  etherization  was 
not  pushed  far  enough.  The  limit  of  toleration  was  not 
yet  known,  and  IMorton  had  removed  the  inhaler  after 
having  induced  unconsciousness;  naturally,  when  allowed 
to  breathe  air,  the  patient  rapidly  recovered.  As  Warren 
stated  two  years  later,  the  exhibition  should  be  "  placed 
in  the  class  of  cases  of  imperfect  etherization." 

The  public  demonstration  had  been  made,  however,  and 


''  Surgical  Records,  Massachusetts  General  Hospital. 


ETHER.  415 

the  facts  were  beyond  any  possible  peradventure.  While 
the  half-stupefied  patient  lay  on  the  table,  Warren  turned 
to  his  audience  and  said,  "  Gentlemen,  this  is  no  hum- 
bug." 

In  order  that  there  might  be  no  further  question,  a 
second  demonstration  was  made  the  following  day,  in  the 
case  of  a  patient  of  Warren's  colleague.  Hay  ward.  The 
operation  was  for  a  large,  fatty  tumor  of  the  shoulder 
in  a  woman,  and  Morton  on  this  second  trial  pushed  the 
ansesthesia  considerably  farther.  The  experiment  was  a 
complete  success.  The  operation  occupied  seven  minutes, 
but  from  start  to  finish  the  woman  lay  in  the  relaxed  atti- 
tude of  profound  sleep,  and  gave  no  indication  of  the 
slightest  sensation. 

Not  long  afterwards  an  amputation  of  the  leg,  with  the 
patient  under  ether,  was  done  by  Hayward ;  and  from 
then  on  the  number  and  scope  of  these  operations  in- 
creased as  the  use  and  physiological  properties  of  ether 
became  better  known  and  rules  for  its  administration 
became  established. 

The  next  step  in  the  exploitation  of  the  great  discovery 
was  its  announcement  to  the  world.  This  was  done,  with 
Morton's  consent,  by  Henry  J.  Bigelow,  in  an  able  and 
exhaustive  paper  read  before  the  American  Academy  of 
Arts  and  Sciences  on  November  3,  1846,  before  the  Bos- 
ton Society  for  Medical  Improvement  on  the  9th  of  the 
same  month,  and  published  in  the  Boston  Medical  and 
Surgical  Journal  on  November  18. 

Bigelow  also  took  measures  that  the  use  of  ether  should 
be  known  in  Europe.  He  wrote  an  account  of  it  to  Fran- 
cis Boott,  a  well-known  physician  of  London,  and  through 
him  its  value  was  soon  communicated  to  the  London  hos- 
pitals, where  it  was  taken  up  with  enthusiasm. 

Two  years  before  this,  the  famous  Liston  had  noted 
with  satisfaction  the  limited  field  of  operative  surgery; 
but  now,  in  December,  1846,  after  amputating  a  thigh 


4i6  MEDICINE    IN    AMERICA. 

AN'itli  the  patient  under  ether  anccsthesia,  he  burst  out 
with,  ''  Hurrah !  Rejoice !  An  American  dentist  has  used 
ether — inhalation  of  it — to  destroy  sensations  in  his  opera- 
tions, and  the  plan  succeeded  in  the  hands  of  Hayward, 
A\'arren,  and  others  in  Boston.  In  six  months  no  opera- 
tion will  be  performed  without  this  previous  preparation. 
Rejoice !'' 

Morton  called  his  mixture  "  letheon."  The  name  is 
said  to  have  been  suggested  by  his  friend  Gould,  who  with 
O.  W.  Holmes  and  H.  J.  Bigelow  took  a  lively  interest  in 
pushing  the  new  discovery.  The  terms  ancesthesia  and 
ancesthetic  were  suggested  by  Holmes. 

So  much  for  the  famous  discovery  of  ether,  America's 
greatest  contribution  to  medical  science  in  the  last  cen- 
tury; probably  the  greatest  contribution  of  any  country 
and  of  any  era;  and  one  fain  would  know  that  the  man 
to  whom  all  living  kind  owes  so  much  had  quietly  gone 
on  his  way  rejoicing,  satisfied  with  his  good  deed,  his 
name  a  household  word  for  all  time. 

No  such  kindly  fate  was  his.  He  tried  to  turn  his  ac- 
complishment into  money ;  he  became  involved  in  law- 
suits to  defend  his  patent  rights ;  he  made  an  enemy  of  his 
best  friend  and  adviser,  and,  except  among  physicians  and 
students  of  the  time,  his  very  name  has  ceased  to  be 
spoken.  It  is  a  dreary  theme  and  demands  from  us  but 
scant  notice,  for  has  it  not  been  told  in  volumes  and  settled 
to  their  own  satisfaction  by  many  men  ? 

On  November  12,  1846,  Ad^orton  secured  a  fourteen 
years'  patent  for  his  use  of  ether,  and  on  the  advice  of  his 
attorney  he  joined  with  himself  Charles  T.  Jackson  in 
the  undertaking.  Jackson,  as  a  presumably  right-minded 
man,  an  eminent  scientist,  and  a  respected  physician,  re- 
fused at  first  to  lend  himself  to  the  patent  business,  but 
was  overpersuaded  by  his  friends,  and  adopted  the  soph- 
istry that  letheon  was  no  longer  a  "  secret  remedy,"  and 
did  not  come  under  the  ban  of  good  ethics. 


ETHER.  417 

Jackson  at  first  proposed  merely  to  charge  Morton  a  fee 
for  services.  Then  he  consented  to  be  joined  with  him 
in  the  letters  patent;  after  they  were  issued  he  made  an 
assignment  of  his  interests  to  Morton  in  return  for  a 
bond,  giving  him  ten  per  cent,  of  the  proceeds  on  all  sales. 
Later,  he  demanded  twenty  and  twenty-five  per  cent., 
which  Morton  refused  to  pay,  and  with  that  the  famous 
battle  was  joined. 

To  the  curious  who  may  be  interested  in  this  old  ques- 
tion, that  lively  book  entitled  "  Trials  of  a  Public  Bene- 
factor" ^  will  appeal.  Much  of  the  book  is  true.  Some 
little  of  it  is  disingenuous;  but  it  was  indorsed  by  such 
eminent  physicians  as  John  Watson,  Willard  Parker,  John 
W.  Francis,  Gurdon  Buck,  and  Valentine  Mott.  In  some 
sense  it  has  become  the  classic  of  the  ether  controversy. 
It  tells  us  practically  all  we  know  about  Morton,  whom  it 
represents  as  a  much  injured  martyr,  and  it  paints  Jack- 
son as  very  black  indeed. 

Our  best  and  final  knowledge  of  the  whole  subject 
comes  from  the  voluminous  reports  of  Congressional  com- 
mittees appointed  to  investigate  the  matter.  Then  there 
is  the  impartial  sketch  of  the  "  Discovery  of  Modern  An- 
aesthesia," by  Laird  W.  Nevins,  of  Chicago,  and  R.  M. 
Hodges's  admirable  account,  already  mentioned. 

That  sulphuric  ether,  when  inhaled,  was  capable  of 
causing  intoxication  and  even  unconsciousness  had  long 
been  known,  but  that  it  was  safe  and  that  it  was  certain 
remained  to  be  demonstrated  to  the  satisfaction  of  the 
scientific  world ;  or,  as  Hodges  puts  it, — 

1.  The  degree  to  which  this  insensibility  could  be  car- 
ried. 

2.  The  safety  with  which  this  could  be  done. 

3.  The  uses  to  which  this  state  could  be  put. 


'  Trials  of  a  Public  Benefactor,  by  Nathan  P.  Rice,  M.D.,  New 
York,  1858. 

27 


41 8  MEDICINE    IN   AMERICA. 

We  have  already  seen  what  part  Jackson  actually  played 
in  answering  these  three  questions. 

The  first  he  had  not  answered  at  all,  as  he  had  had  no 
experience. 

The  safety  he  had  at  first  assumed;  but  later,  when 
Morton  had  asked  for  a  certificate  of  the  safety  of  ether, 
he  had  refused  it,  on  the  proper  grounds  of  lack  of 
knowledge. 

The  answer  to  the  third  question  lay  beyond  his  juris- 
diction, as  he  was  no  surgeon. 

As  a  matter  of  fact,  Jackson  took  no  interest  in  Mor- 
ton's work  and  the  exhibition  of  ether  until  some  weeks 
after  the  successful  demonstrations  at  the  Massachusetts 
General  Hospital,  and  then  only  because  he  saw  a  way 
to  make  a  little  money,  which  at  the  time  he  is  said  to  have 
greatly  needed.  He  was  not  present  at  the  hospital  on  the 
momentous  October  i6,  and  a  few  days  later  he  went  off 
to  a  mine  in  Maryland  in  which  he  was  interested,  and 
did  not  return  until  the  middle  of  November.  He  took 
no  part  whatever  in  introducing  ether  to  practice,  and 
w^hen  Warren  invited  him  to  give  the  anaesthetic  at  the 
hospital  for  the  first  capital  operation  performed  there,  he 
declined  to  be  present. 

In  spite  of  these  well-known  facts,  when  he  fancied  he 
saw  that  ]\Iorton  was  in  a  fair  way  to  make  a  fortune  out 
of  his  discovery,  he  began  demanding  money  and  per- 
quisites from  him ;  and  when  these  requisitions  failed,  he 
went  so  far  as  to  blackmail  him.  vilify  him,  and  event- 
ually to  spread  abroad  slanders,  for  which  he  was  ar- 
rested and  threatened  with  a  criminal  suit. 

Before  it  came  to  this  he  had  taken  every  sort  of  under- 
hand means  to  announce  the  discovery  in  Europe  as  his 
own ;  he  had  sent  early  information  to  the  French  Acad- 
emy of  Sciences,  without  so  much  as  mentioning  Morton's 
name,  and  had  received  from  France  the  Cross  of  the 
Legion  of  Honor. 


ETHER. 


419 


In  185 1  Jackson  prepared  for  von  Humboldt  a  care- 
fully matured  statements  of  his  claims.  In  this  paper  he 
told  how  he  had,  from  his  student  days,  been  interested 
in  the  work  of  Humphry  Davy  in  connection  with  an- 
aesthetic agents ;  how  he  had  experimented  with  protoxide 
of  nitrogen  and  ether ;  how  he  had  found  the  fumes  of  the 
latter  to  relieve  him  from  the  agony  of  inhaled  chlorine 
gas,  and  even  to  cause  unconsciousness, — that  last  in  the 
winter  of  1841-42;  and  that  he  had  therefore  drawn  the 
following  conclusions : 

First.  That  pain  ceased  before  unconsciousness  was 
complete. 

Second.  That  consciousness  returned  before  pain  re- 
turned. 

Third.  That  insensibility  continued  long  enough  for 
any  ordinary  surgical  operation  to  be  performed  while  the 
patient  was  unconscious.     . 

Fourth.  That  the  vital  functions  were  in  no  wise 
affected. 

Jackson  claimed  to  have  discovered  all  this  four  years 
before  Morton's  public  exposition. 

The  answer  is  furnished  by  an  anecdote  of  Velpeau. 
When  the  subject  of  ether  was  first  agitated  before  the 
French  Academy,  a  person  present  rose  and  declared  him- 
self to  have  made  the  discovery  several  years  before. 
Whereupon  Velpeau  exclaimed,  "  Sir,  you  did  not  make 
the  discovery !  Else  why  have  you  suffered  thousands  of 
the  human  race  to  undergo  the  tortures  of  surgery  during 
these  years,  if  it  was  in  your  power,  by  a  word,  to  have 
relieved  them?"  '^ 

The  authorities  of  the  Massachusetts  General  Hospital, 
trustees  and  surgeons,  were  unanimous  in  recognizing 
Morton  as  the  true  discoverer.  The  following  is  their 
contribution : 


Boston  Medical  and  Surgical  Journal,  June  30,   1847. 


420  MEDICINE    IN   AMERICA. 

"  Boston,  May  12,  1848. 
"  Dear  Sir  : — 

"  At  a  meeting  of  the  Board  of  Trustees  of  the  Mas- 
sachusetts General  Hospital,  a  few  weeks  since,  it  was 
informally  suggested  that  a  limited  subscription  of  one 
thousand  dollars  shall  be  raised  for  your  benefit  in  ac- 
knowledgment of  your  services  in  the  late  ether  discovery ; 
no  one  to  be  asked  to  subscribe  more  than  ten  dollars. 
We  consented  to  act  as  a  committee  to  receive  and  apply 
the  proceeds  of  this  subscription.  The  proposed  sum 
having  been  obtained,  we  have  now  the  pleasure  of  trans- 
mitting it  to  you.  We  also  enclose  the  subscription  book 
in  a  casket  which  accompanies  this  note.  Among  its  sig- 
natures you  will  find  names  of  not  a  few  of  those  most  dis- 
tinguished among  us  for  worth  and  intelligence ;  ^  and  it 
may  be  remarked  that  it  is  signed  by  every  member  of  the 
Board  of  Trustees. 

"  You  will,  we  are  sure,  highly  value  this  iirst  testi- 
monial, slight  as  it  is,  of  the  gratitude  of  your  fellow- 
citizens.  That  you  may  hereafter  receive  an  adequate 
national  reward  is  the  sincere  wish  of  your  obedient  ser- 
vants, 

"  Samuel  Frothingham. 
"  Thomas  B.  Curtis. 

"  To  Dr.  William  T.  G.  Morton." 

In  glancing  back  over  the  various  claims  of  those  whose 
names  are  conspicuous  in  the  anaesthesia  controversy,  we 


*  Among  the  well-known  subscribers  to  this  fund  were  Josiah 
Quincy,  Jr.,  Abbott  Lawrence,  S.  A.  Eliot,  Amos  Lawrence,  William 
Appleton,  J.  L  Bowditch,  R.  G.  Shaw,  Charles  Amory,  William  Stur- 
gis,  John  Bryant,  J.  A.  Lowell,  Thomas  Dwight,  Theodore  Lyman. 
F.  H.  Bradlee,  Robert  Hooper,  Charles  Jackson,  James  Jackson,  Mar- 
cus Morton,  G.  C.  Shattuck,  George  Hayward,  Thomas  Lee,  J.  C. 
Warren,  W.  H.  Prescott,  Rufus  Choate,  William  Ropes,  C.  F.  Adams, 
Daniel  Webster,  John  Romans,  R.  H.  Dana,  Augustus  Thorndike, 
Russell  Sturgis,  H.  H.  Hunnewell,  J.  P.  Higginson,  and  about  thirty 
others. 


ETHER.  421 

see  that  the  amiable  Long  never  announced  his  discovery 
to  a  suffering  world;  that  Wells  failed  to  push  his  use 
of  nitrous  oxide  and  ether  far  enough  to  show  their 
value;  that  the  jealous  and  petulant  Jackson  made  no 
practical  application  of  his  knowledge  of  ether, — a 
knowledge  which  he  shared  in  common  with  chemists 
the  world  over, — and  that  he  forced  his  claims  only  when 
he  saw  his  former  pupil's  energy  and  courage  likely  to 
be  rewarded  by  fame  and  fortune. 

The  verdict  of  those  best  qualified  to  judge  assigned 
the  credit  of  the  ether  discovery  to  Morton.  Yet  the 
man  went  unrewarded, — his  life  apparently  a  failure, 
his  practice  destroyed,  his  family  scattered,  ruined,  and 
wretched,  his  health  broken,  and  premature  death,  a 
happy  release  from  a  harassed  and  miserable  existence. 

It  seems  as  though  all  this  tribulation  could  be  traced 
to  the  wretched  patent  and  the  endeavor  to  secure  a  for- 
tune through  a  monopoly  of  what  had  been  proven  a  prime 
necessity  of  life. 

The  patent  failed  almost  at  the  outset.  Morton  died  in 
poverty,  and  neither  of  these  circumstances  is  creditable 
to  our  national  probity  and  gratitude. 

Briefly,  the  course  of  events  was  this. 

Morton  early  revealed  the  nature  of  "  letheon"  to  the 
Massachusetts  General  Hospital,  and  assigned  to  the  Hos- 
pital and  other  charitable  institutions  the  right  to  use 
ether.  He  tried  to  interest  the  Federal  government  in 
ether  anaesthesia  for  military  purposes,  but  was  not  lis- 
tened to.  In  spite  of  this,  and  immediately  afterwards,  in 
the  Mexican  War,  the  army  was  provided  with  ether,  and 
the  surgeons  used  it  extensively  in  the  campaigns  follow- 
ing. The  government  had  infringed  its  own  patent,  and 
that  was  the  end  of  the  monopoly.  Straightway  every 
doctor  in  the  land  felt  that  he  might  appropriate  the  ether 
with  impunity,  and  did  so.  Morton's  licensees  for  the 
sale  of  "  letheon"  saw  themselves  ruined,  and  they  turned 


422  MEDICINE   IN    AMERICA. 

upon  him  for  redress;  he  and  they  floundered  through 
countless  legal  suits,  where  all  parties  were  beggars  to- 
gether. Then  Morton,  with  the  backing  of  the  Boston 
profession,  petitioned  Congress  for  redress. 

The  memorial,  written  by  himself,  was  a  brief  state- 
ment of  the  leading  facts  in  the  case.  It  represented  that 
while  in  the  prosperous  practice  of  the  dental  profession  he 
"  saw  frequent  instances  of  physical  suffering,  and  was 
induced  to  consider  whether  there  might  not  be  some 
means  of  alleviating  such  suffering,  and  rendering  opera- 
tions less  painful  to  those  obliged  to  submit  to  them." 
That  in  pursuance  of  this  object  he  had  experimented 
upon  himself,  afterwards  upon  others,  until  success  had 
crowned  his  efforts. 

To  this  was  added  a  brief  narrative  of  his  outlays  and 
losses,  with  the  conclusion  that,  "  considering  the  nature 
of  the  discovery,  the  benefit  which  it  confers,  and  must 
continue  to  confer  so  long  as  nature  lasts,  upon  humanity ; 
the  price  at  which  your  petitioner  effected  it ;  in  the 
serious  injury  to  his  business ;  the  detriment  to  his  health  ; 
the  entire  absence  of  any  remuneration  from  the  privi- 
leges under  his  patent;  and  that  it  is  of  direct  benefit  to 
the  government  by  its  use  in  the  army  and  na\-}' ;  you 
should  grant  him  such  relief  as  might  seem  to  you  suffi- 
cient to  restore  him  at  least  to  that  position  in  which  he 
was  before  he  made  known  to  the  world  a  discovery  which 
enables  man  to  undergo,  without  the  sense  of  pain,  the 
severest  physical  trials  to  which  human  nature  is  sub- 
ject." 

The  faithful  dentist's  admirable  unvarnished  state- 
ments and  his  practical  demonstrations  carried  conviction 
to  numerous  committees  of  Congress. 

Jackson  fought  him  with  all  the  weapons  at  his  com- 
mand, and  was  given  careful  hearings,  but  Morton  carried 
the  day.  The  committees  made  various  recommendations 
in  his  favor,  the  most  satisfactory  advising  a  grant  to 


ETHER. 


423 


him  of  one  hundred  thousand  dollars  from  the  national 
treasury. 

Unfortunately  for  Morton,  these  recommendations,  ex- 
tending over  years,  never  came  to  anything,  as  the  Con- 
gress could  not  be  brought  to  act  upon  them. 

Finally,  in  1854,  Morton  became  hopeless  of  Congres- 
sional action,  and  memorialized  the  President,  praying 
him  to  grant  him  compensation  for  the  use  of  the  discov- 
ery of  practical  anaesthesia,  or  to  issue  the  necessary 
orders  to  medical  officers  under  national  control  to  desist 
from  further  infringement  of  the  patent  right.  The 
President  received  the  application  and  was  about  to  order 
a  liberal  compensation,  when  the  Secretary  of  War,  Jef- 
ferson Davis,  induced  him  to  require,  as  a  prerequisite,  a 
suit  in  one  of  the  United  States  Courts  and  a  judgment 
against  a  government  surgeon  for  using  ether  without 
compensation  to  the  patentee. 

Accordingly,  Morton  brought  an  action  against  Charles 
A.  Davis,  of  the  Marine  Hospital  Service,  and  secured  a 
judgment.  Then  came  a  change  in  administration,  and 
the  new  Secretary  of  the  Treasury  refused  to  carry  out 
the  order  until  Morton  had  brought  further  test  suits. 
Some  time  afterwards,  therefore,  he  brought  suit  against 
the  New  York  Eye  Infirmary,  when  a  decision,  afterwards 
concurred  in  by  the  Supreme  Court,  was  returned  against 
him. 

That  was  the  end  of  his  hopes.  The  story  is  a  curious 
sermon  in  ethics.  It  was  not  Morton's  discovery  of  the 
properties  of  ether — his  announcement  to  the  world — that 
ruined  him.  It  was  his  attempt  to  establish  a  monopoly, 
and  that  stirred  up  the  bitter  rivalry  which  led  to  viola- 
tion of  its  contracts  by  the  government,  involving  him  in 
endless  petitions  and  lawsuits,  and  left  him  a  broken- 
hearted man. 

Those  lawsuits  gave  rise  to  a  final  and  crushing  blow, 
administered  by  that  large  and  influential  body  of  his  fel- 


424  MEDICINE    IN   AMERICA. 

lows,®  the  American  Medical  Association.  The  year  after 
the  decision  in  the  case  of  the  New  York  Eye  Infirmary, 
the  Association  ^°  passed  resolutions  of  scathing  censure 
against  Morton.  To-day,  in  view  of  the  circumstances 
under  which  he  had  brought  his  suit, — merely  to  make 
a  test  case,  by  direction  of  the  government,  and  after 
years  of  waiting  for  what  he  believed  his  rights, — this 
action  of  the  American  Medical  Association  seems  essen- 
tially unjust. 

Morton  did  not  live  long  after  this.  He  had  secured 
some  rewards.  He  was  invested  by  Russia  with  the  Or- 
der of  Saint  Vladimir;  by  Sweden  with  the  Order  of 
Vasa.  The  French  Academy  divided  the  Montyon  Prize 
of  one  thousand  dollars  between  Jackson  and  himself. 

He  died  prematurely  of  an  apoplexy,  in  New  York,  on 
July  15,  1868,  in  his  forty-ninth  year. 


°  He  had  received  the  honorary  M.D.  from  Washington  University, 
Bahimore,  in  1849. 

"  By  Dr.  Noyes,  of  New  York. — Whereas,  In  the  appropriation  bill 
now  pending  in  Congress  is  a  claim  donating  to  Dr.  W.  T.  G.  Morton, 
of  Boston,  the  sum  of  two  hundred  thousand  dollars  as  a  recognition 
of  his  services  in  introducing  sulphuric  ether  as  an  anaesthetic  agent; 
and 

Whereas,  The  said  Dr.  Morton,  by  suits  brought  against  charitable 
medical  institutions  for  infringements  of  an  alleged  patent  covering 
all  anaesthetic  agents,  not  claming  sulphuric  ether  only,  but  the  state 
of  anaesthesia,  however  produced,  as  his  invention,  has  by  this  act 
put  himself  beyond  the  pale  of  an  honorable  profession  and  of  true 
laborers  in  the  cause  of  science  and  humanity;    therefore 

Resolved,  That  the  American  Medical  Association  enter  their  pro- 
test against  any  appropriation  to  Dr.  Morton,  on  the  ground  of  his 
unworthy  conduct,  also  because  of  his  unwarrantable  assumption  of 
a  patent  right  in  anaesthesia,  and  further  because  private  beneficence 
in  Boston,  New  York,  Philadelphia,  and  other  places  has  already 
sufficiently  rewarded  him  for  any  claim  which  he  may  justly  urge. 

Resolved,  That  a  copy  of  these  resolutions,  if  passed,  be  forwarded 
to  the  Chairman  of  the  Committee  on  Ways  and  Means. 

Dr.  Mauran,  of  Rhode  Island,  moved  the  adoption  of  both  resolu- 
tions, which  were  carried. 

Vol.  XV.  page  53,  Transactions  of  the  American  Medical  Asso- 
ciation. 


ETHER. 


425 


It  is  a  discouraging  story,  but  time  and  history  are  at 
last  placing  the  honor  where  it  belongs, — with  Morton, 
who  for  his  errors  most  certainly  was  punished  beyond  his 
deserts. 

We  come  to  the  end  of  the  ether  drama,  to  find  it  inade- 
quate and  disappointing.  The  stage  is  well  set  and  the 
house  full,  but  the  actors  fail  in  their  parts,  and  the 
audience  does  not  applaud. 

It  is  all  very  different  from  those  other  medical  mercies 
which  the  mills  of  God  slowly  have  ground  out  for  us. 
I  suppose  the  underlying  flaw  in  it  all  is  that  we  cannot 
make  of  Morton  an  heroic  figure.  To  satisfy  the  unities, 
there  should  have  been  a  god  descending  out  of  the  ma- 
chine, bearing  in  his  hands  the  great  gift  to  suffering 
mortals.  Surcease  from  pain  should  have  been  for  all, — 
gladly  bestowed,  thankfully  received.  But,  instead,  we 
have  the  dollar  put  above  the  man,  and  man  turning  to 
demand  his  rights.  The  gift  grudgingly  offered.  The 
recognition  cold  and  forced. 

No  words  as  yet  have  told  of  the  benefit  to  man.  Many 
have  tried  to  write  or  speak,  but  in  terms  inadequate.  Oli- 
ver Wendell  Holmes  and  Jacob  Bigelow,  both  old  men 
eloquent,  have  written  down  their  thoughts.^ ^ 

Splendid  as  was  the  conception  of  what  anaesthesia 
might  do  for  men,  the  harvest  was  many  years  in  coming 
to  fruition,  because  painless  surgery  was  still  dangerous 
surgery,  and  for  a  long  time  surgeons  saw  clearly  the  risks 
of  operations,  though  for  patients  the  terror  was  banished. 


"  So  long  ago  as  1847  Holmes  said  to  his  students,  "  Here  almost 
within  the  present  year,  the  unborrowed  discovery  first  saw  the  light, 
which  has  compassed  the  whole  earth  before  the  sun  could  complete 
his  circle  in  the  zodiac.  There  are  thousands  who  never  heard  of 
the  American  Revolution,  who  know  not  whether  an  American  citi- 
zen has  the  color  of  a  Carib  or  a  Caucasian,  to  whom  the  name  of 
Boston  is  familiar  through  this  medical  discovery.  In  this  very 
hour  while  I  am  speaking  how  many  human  creatures  are  cheated  of 
pangs  which  seemed  inevitable  as  the  common  doom  of  mortality,  and 


426  MEDICINE    IN   AMERICA. 

Of  course  there  was,  even  at  first,  some  increase  in  the 
total  number  of  operations:  the  inevitable  capital  opera- 
tions were  soon  much  more  common  and  done  with  the 
patient's  ready  consent.  More  radical  traumatic  surgery, 
too,  became  frequent,  as  well  as  the  use  of  ether  in  labor 
and  as  an  aid  in  diagnosis.  Pain  was  banished,  but  more 
than  thirty  years  were  to  elapse  before  asepsis,  the  twin- 
fellow  of  anaesthesia,  became  recognized  as  the  necessary 
corollary  for  the  final  perfecting  of  surgical  advance. 

Then,  indeed,  the  art  began  to  expand  with  those  mar- 
vellous bounds  at  which  the  world  still  stands  agape. 
Lacking  ether,  we  should  lack  all;  and  with  those  two 
men  so  great  in  nineteenth-century  rnedicine, — Pasteur, 
the  French  scientist,  and  Lister,  the  Scotch  surgeon, — we 
must  link  Morton,  the  American  dentist. 

On  October  i6,  1896,  fifty  years  after  Morton's  famous 
demonstration  at  the  Massachusetts  General  Hospital, 
representatives  of  all  the  scientific  world  gathered  in  that 
institution  and  celebrated  the  "  Semicentennial  of  An- 
aesthesia." Among  them  the  name  of  Morton  only  was 
heard,  and  the  words  of  the  venerable  sage,  Jacob  Bige- 
low, — words  written  thirty  years  ago, — were  heartily  sec- 
onded :  "  The  suffering  and  now  exempted  world  have 
not  forgotten  the  poor  dentist  who,  amid  poverty,  priva- 
tion, and  discouragement,  matured  and  established  the 
most  beneficent  discovery  which  has  blessed  humanity 
since  the  primeval  days  of  Paradise." 


lulled  by  the  strange  magic  of  the  enchanted  goblet,  held  for  a 
moment  to  their  lips,  into  a  repose  which  has  something  of  ecstasy 
in  its  dreamy  slumbers. 

"  The  knife  is  searching  for  disease,  the  pulleys  are  dragging  back 
dislocated  limbs,  nature  herself  is  working  out  the  primal  curse 
which  doomed  the  tenderest  of  her  creatures  to  the  sharpest  of  her 
trials,  but  the  fierce  extremity  of  suffering  has  been  steeped  in  the 
waters  of  forgetfulness,  and  the  deepest  furrow  in  the  knotted  brow 
of  agony  has  been  smoothed  forever." 


CHAPTER    XV. 

THE    NINETEENTH     CENTURY.        THE    FOUNDING    OF    THE 
AMERICAN   MEDICAL  ASSOCIATION,    1 847. 

More  than  half  a  century  ago,  young  doctors  of  the 
country,  stimulated  by  the  world-wide  movement  of  scien- 
tific advance,  and  encouraged  by  the  words  and  writings 
of  such  teachers  as  Hosack,  Chapman,  Drake,  and  War- 
ren, resolved  to  come  together  to  form  a  national  organi- 
zation for  the  uplifting  of  the  profession.  It  was  a  great 
undertaking ;  full  of  difficulty,  but  full  of  promise.  As  a 
whole,  we  were  in  need  of  improvement.  In  somewhat 
exaggerated  words.  Chapman  said  of  American  doctors 
of  the  period,  "  The  profession  to  which  we  belong,  once 
venerated  on  account  of  its  antiquity,  its  various  and  pro- 
found science,  its  elegant  literature,  its  polite  accomplish- 
ments, its  virtues,  has  become  corrupt  and  degenerate,  to 
the  forfeiture  of  its  social  position,  and  with  it  of  the 
homage  it  formerly  received  spontaneously  and  univer- 
sally. Do  not  suppose  that  I  comprise  the  whole  profes- 
sion in  this  reprobation."  The  statement  was  wide  of  the 
mark,  so  far  as  there  being  a  degeneracy  was  concerned. 
Affairs  were  bad  enough,  but  they  had  never  been  any 
better,  except  to  the  jealous  eye  of  a  fond  old  man  looking 
back  upon  his  youth  and  the  times  before ;  they  were  gen- 
erally bad,  however,  as  compared  with  the  best  among 
ourselves  and  in  Europe;  and  so  the  purpose  rose  to  try 
to  improve  them. 

That  which  troubled  men  mostly  in  those  days  was  the 
state  of  medical  education,  a  topic  ever  new  and  increasing 
in  importance  as  the  years  pass.     As  the  early  historian  ^ 

^  History  of  the  American  Medical  Arsociation  by  one  of  its  mem- 
bers, New  Jersey  Medical  Reporter,  vol.  vii.,  1854. 

427 


428  MEDICINE    IN    AMERICA. 

of  the  movement  says,  during  the  fifteen  years  intervening 
between  1830  and  1845  the  number  of  medical  schools  in 
this  country  more  than  doubled,  leading  to  active  rivalry, 
and  a  competition  which  aimed  mostly  at  an  increased 
number  of  students,  and  fees  for  the  pockets  of  the  teach- 
ers. The  schools  generally  were  private  enterprises,  at 
times  avowedly  business  ventures,  at  times  in  the  guise  of 
departments  of  some  established  seat  of  learning;  rarely 
endowed,  and,  by  their  very  nature,  little  calculated  to 
give  their  matriculants  more  than  a  smattering  of  the 
science  and  art  of  medicine.  There  was  no  uniform  re- 
quirement for  the  degree  and  no  preliminary  requirement 
whatever  for  matriculation.  Sixteen  weeks  were  very 
generally  adopted  as  the  length  of  the  college  term,  and 
often  it  was  thirteen.  In  New  England  and  Philadelphia 
the  inadequacy  of  this  training  had  agitated  men,  and  in 
1835  the  Faculty  of  the  Medical  College  of  Georgia  actu- 
ally had  made  a  formal  proposal  for  the  holding  of  a  con- 
vention of  delegates  from  all  the  medical  colleges  of  the 
country.  The  proposition  met  with  the  fate  of  most 
propositions  coming  from  obscure  sources.  Many  of  the 
small  colleges  thought  well  of  it,  but  the  old  establish- 
ments ignored  it,  and  it  fell  to  the  ground.  The  plan  de- 
served a  better  fate,  and  the  curious  fact  about  it  is  that  it 
came  from  one  of  those  very  institutions  about  which  men 
were  complaining.  There  must  have  been  wise  and  honest 
teachers  in  that  Georgia  College. 

The  movement  would  not  be  suppressed.  Since  the 
self-satisfied  older  colleges  would  not  bestir  themselves. 
and  the  young  colleges  could  not  act  alone,  it  remained 
to  be  seen  what  those  medical  bodies,  other  than  the  col- 
leges, could  do.  Those  other  bodies  were  the  various  so- 
cieties in  the  States,  counties,  and  towns. 

The  first  of  them  to  take  action  was  the  Medical  So- 
ciety of  the  State  of  New  York,  at  its  annual  session  in 
February,   1839.     Men  kept  talking  of  the  existing  un- 


AMERICAN    MEDICAL   ASSOCIATION. 


429 


satisfactory  state  of  affairs  and  declaring  that  it  was  un- 
wise for  those  who  did  the  teaching  to  be  allowed  to  con- 
fer the  degree.  As  the  conferring  of  the  degree  carried 
with  it,  at  that  time,  the  license  to  practise,  the  danger  of 
abuse  was  more  apparent  than  it  is  at  present,  when  the 
degree  carries  with  it  no  such  license.^ 

As  a  result  of  this  feeling,  the  Society  passed  by  a  large 
majority  a  resolution  affirming  that  the  business  of  teach- 
ing should  be  separated  as  far  as  possible  from  the  privi- 
lege of  granting  diplomas. 

Consequently,  John  McCall,  of  Utica,  offered  the  fol- 
lowing preamble  and  resolution : 

"  Whereas^  A  National  Medical  Convention  would 
advance,  in  the  apprehension  of  this  Society,  the  cause 
of  the  medical  profession  throughout  our  land,  in  thus 
affording  an  interchange  of  views  and  sentiments  on  the 
most  interesting  of  all  subjects, — that  involving  men's 
health,  and  the  means  of  securing  or  recovering  the  same ; 
therefore, 

"  Resolved,  That  in  our  opinion  such  convention  is 
deemed  advisable  and  important;  and  we  would  hence 
recommend  that  it  be  held  in  the  year  1840,  on  the  first 
Tuesday  in  May  of  that  year,  in  the  city  of  Philadelphia ; 
and  that  it  consist  of  three  delegates  from  each  State 
Medical  Society,  and  from  each  regularly  constituted 
Medical  School  in  the  United  States,  and  that  the  presi- 
dent and  secretary  of  this  Society  be,  and  they  are  hereby, 
instructed  and  required  to  transmit  as  soon  as  may  be  a 
circular  to  that  effect  to  each  State  Medical  Society  and 
Medical  School  in  said  United  States." 

That  was  a  good  stirring  resolution.  It  was  carried, 
and  the  steps  were  taken  to  effect  its  purposes;    but  it 


^  Our  State  Boards  now  grant  the  license  to  practise  after  the 
candidate  has  passed  a  State  examination ;  and  a  medical  school 
diploma  is  a  prerequisite  to  taking  such  examination;  formerly, 
there  were  no  State  Boards. 


430  ^lEDICINE   IN    AMERICA. 

seems  not  to  have  been  timely.  At  an}^  rate,  those  invited 
did  not  respond,  and  the  scheme  fell  through. 

The  thoughts  embodied  in  the  resolution  did  not  lie 
fallow,  however.  All  over  the  country  the  discussion  of 
the  problem  and  the  question  of  medical  education,  and 
of  the  unwisdom  of  the  teachers  granting  the  diplomas, 
went  on.  So  the  talk  continued  for  five  years  longer, 
when,  in  1844,  the  New  York  Society  again  bestirred 
itself  in  the  matter.  The  question  was  brought  to  a  focus 
by  two  series  of  resolutions,  the  one  offered  by  Alexander 
Thompson,  of  Cayuga  County,  the  other  by  N.  S.  Davis, 
a  new  delegate  from  Broome  County. 

The  resolutions  stated  that  a  four  months'  term  of 
schooling  was  altogether  too  short,  and  that  combining  the 
teaching  and  licensing  powers  in  the  same  body  of  men 
was  impolitic  and  liable  to  abuse.  As  a  result  of  dis- 
cussion, the  resolutions  were  referred  to  a  committee,  of 
which  Davis  was  made  chairman.  Then  followed  a  year 
of  active  correspondence  and  hard  work,  when  again,  in 
February,  1845,  two  reports  were  presented  by  the  Com- 
mittee to  the  Society, — one  from  Davis,  the  chairman, 
endorsing  the  proposition  of  the  year  before,  the  other 
taking  a  different  view  of  the  subject.  The  arguments 
of  the  reformers  in  the  resulting  debate  were  the  same 
as  those  already  given.  In  opposition,  it  was  urged  that, 
though  existing  conditions  in  New  York  State  were  un- 
satisfactor3^  the  same  was  true  of  the  other  States,  and 
that  a  high  standard  of  education  established  in  New  York 
would  result  merely  in  driving  students  out  of  the  State 
and  in  ruining  the  schools. 

Upon  the  close  of  this  debate,  while  the  subject  still 
hung  fire  and  was  about  to  be  postponed,  it  was  suggested 
to  Davis  that  the  matter  might  be  arranged  by  calling 
a  convention  of  delegates  from  all  the  colleges  in  the 
country  and  inducing  them  to  act  in  concert.  He  was 
fired  by  the  idea,  and,  unaware  that  any  similar  attempt 


AMERICAN    MEDICAL   ASSOCIATION.     431 

had  previously  been  made,  rose  and  offered  this  preamble 
with  resolution : 

"  Whereas,  It  is  beHeved  that  a  National  Convention 
would  be  conducive  to  the  elevation  of  the  standard  of 
medical  education  in  the  United  States;  and  whereas 
there  is  no  mode  of  accomplishing  so  desirable  an  object 
without  concert  of  action  on  the  part  of  the  medical  col- 
leges, societies,  and  institutions  of  all  the  States,  there- 
fore, 

"  Resolved,  That  the  New  York  State  Medical  Society 
earnestly  recommend  a  National  Convention  of  delegates 
from  medical  societies  and  colleges  in  the  whole  Union, 
to  convene  in  the  city  of  New  York,  on  the  first  Tues- 
day in  May  in  the  year  1846,  for  the  purpose  of  adopting 
some  concerted  action  on  the  subject  set  forth  in  the 
foregoing  preamble. 

"  Resolved,  That  a  committee  of  three  be  appointed  to 
carry  the  foregoing  resolution  into  effect." 

Such  was  Davis's  motion.  It  marks  the  inception  of 
that  great  organization,  "  The  American  Medical  Asso- 
ciation;" and  it  brings  into  the  field  of  history,  clearly 
and  for  the  first  time,  a  distinguished  man, — a  man  who 
is  living  at  this  writing,  and  is  known  to  us  in  his  vener- 
able age  as  "  The  Father  of  the  American  Medical  Asso- 
ciation."   Of  such  a  man  we  should  hear  some  few  words. 

Nathan  Smith  Davis  was  born  on  January  9,  181 7,  at 
Greene,  New  York,  a  little  town  in  Chenango  County, 
some  fifty  miles  south  of  Syracuse.  The  region  had  been 
opened  to  settlers,  mostly  from  Connecticut,  about  twenty 
years  before,  and  was  still  a  crude  frontier  community. 
There  were  schools  there,  as  there  were  wherever  our 
ancestors  moved  forward, — good  schools,  too,  many  of 
them, — and  Davis  found  his  early  education  there  and 
at  the  neighboring  academy  in  Cazenovia.  Then  he  went 
for  his  medical  education  to  Fairfield,  the  college  of  the 
Western  District  of  the  "  Physicians  and  Surgeons."     It 


43^2  MEDICINE    IN   AMERICA. 

was  there  that  we  shall  see  Theodoric  Romeyn  Beck  at 
work.  Davis  was  graduated  thence  a  Doctor  of  Medicine 
in  January,  1837,  at  the  age  of  twenty. 

Immediately  on  his  graduation  he  settled  in  practice  at 
the  village  of  Vienna,  a  few  miles  west  of  Utica,  New 
York ;  but  after  some  months  he  resolved  to  seek  a  larger 
field,  and  removed  to  the  town  of  Binghamton,  in  what 
is  called  the  southern  tier,  not  far  from  the  Pennsylvanian 
border.  Binghamton  is  in  Broome  County,  and  it  was  in 
1844,  when  he  had  been  seven  years  in  practice  and  was 
but  twenty-seven  years  old,  that  Davis  was  sent  as  a  dele- 
gate from  his  county  to  the  State  Medical  Convention 
where  we  met  him. 

His  subsequent  career  must  be  briefly  traced,  and  we 
shall  hear  but  little  more  of  him  in  connection  with  the 
American  Medical  Association. 

After  ten  years  of  active  and  successful  practice  in 
Binghamton,  he  resolved  to  enter  upon  a  city  practice.  In 
1847  he  went  to  New  York,  where  he  remained  a  couple 
of  years,  and  then  in  1849  settled  finally  in  Chicago,  the 
scene  of  all  his  subsequent  labors.  The  immediate  cause 
of  his  Western  migration  was  to  fill  a  professorship  in  the 
Rush  Medical  College,  then  but  five  years  established. 

Of  Davis's  life  during  the  past  half-century  it  is  not 
yet  time  to  speak  more  than  in  outline.  He  has  been  a 
constant  advocate  of  improving  medical  education,  and, 
as  the  founder  of  the  Chicago  Medical  College  in  i860, 
was  a  pioneer  in  lengthening  the  medical  course.  In  nu- 
merous other  good  works  for  the  profession  he  has  had  a 
part.  He  was  Secretary-General  and,  later.  President  of 
the  International  Medical  Congress  in  1887;  a  founder 
of  the  Illinois  Medical  Society,  the  Chicago  Academy  of 
Sciences,  the  Chicago  Historical  Society,  and  kindred  en- 
terprises. He  has  been  a  frequent  and  valuable  contribu- 
tor to  medical  literature;  producing  among  many  other 
good  works  an  essay  on  the  "  Physiology  of  the  Nervous 


AMERICAN    MEDICAL    ASSOCIATION.      433 

System"  (1841)  ;  "  History  of  Medical  Education  in  the 
United  States"  (1851)  ;  "  Practice  of  Medicine  and  Clin- 
ical Lectures."  In  New  York  he  was  editor  of  the  An- 
nalist; in  Chicago  he  edited  the  Chicago  Medical  Jour- 
nal and  founded  the  Chicago  Medical  Examiner.  For  six 
years  he  edited  the  Journal  of  the  American  Medical  As- 
sociation. And  always  since  its  founding  he  has  been  the 
earnest  supporter  and  faithful,  devoted  servant  of  the 
Association  to  which  he  gave  that  initial  impulse  in  1845. 

Truly  it  has  been  a  remarkable  and  useful  life. 

That  resolution  of  Davis,  at  the  New  York  State  meet- 
ing of  1845,  calling  for  a  National  Convention,  did  not 
receive  a  very  enthusiastic  reception.  The  older  members 
recalled  the  previous  failure,  and  to  most  the  scheme 
seemed  Utopian  and  impracticable.  Still,  it  appeared  that 
no  harm  could  come  of  the  project,  so  the  mover  of  the 
resolutions  was  humored,  his  plan  adopted,  and  himself 
named  chairman  of  a  committee  of  three  to  carry  it  into 
effect. 

The  following  year  was  a  busy  one  for  the  committee, 
in  corresponding  with  numerous  Schools  and  Societies 
throughout  the  country.  Somewhat  to  the  surprise  of  the 
enthusiastic  Davis,  the  replies  to  his  letters  were  favorable 
for  the  most  part ;  and  the  great  majority  of  the  organiza- 
tions addressed  agreed  to  send  delegates  to  the  Conven- 
tion. To  his  chagrin,  however,  three  of  the  oldest  and 
strongest  Schools  in  the  country  civilly  declined  to  have 
any  part  in  the  movement, — the  Pennsylvania  and  Jeffer- 
son Schools  of  Philadelphia  and  the  Harvard  School  of 
Boston.  Their  reasons  seem  to  have  been  short-sighted, 
due  to  an  attitude  of  self-satisfaction  and  a  not  unreason- 
able fear  of  committing  themselves  with  a  body  of  men 
of  whose  purposes  they  were  suspicious, — groundless 
fears,  from  which  their  conservatism  recovered  in  a  year 
or  two. 

The  names  of  the  prominent  men  who  favored  the  plan 

28 


434 


MEDICINE   IN   AMERICA. 


promised  a  good  measure  of  success,  however;  and,  be- 
sides individual  indorsers,  delegates  were  pledged  from 
Medical  Societies  and  Colleges  in  Maine,  New  Hamp- 
shire, Connecticut,  New  Jersey,  Delaware,  the  District  of 
Columbia,  South  Carolina,  Georgia,  Mississippi,  Loui- 
siana, Tennessee,  Kentucky,  Ohio,  Indiana,  and  New 
York.  The  proposed  Convention  was  warmly  favored 
also  by  nearly  every  medical  journal  in  the  country. 

So  encouraging  a  showing  stimulated  the  New  York 
State  Society  to  go  on  with  the  undertaking.  Sixteen 
delegates  were  therefore  appointed  by  it  to  attend  the 
Convention,  and  an  invitation  from  the  faculty  of  the 
New  York  University  to  make  use  of  a  hall  in  their 
building  was  accepted. 

In  the  mass  of  journal  articles  (which  appeared  during 
the  winter  of  1845-46)  concerning  the  matter,  the  New 
York  Journal  of  Medicine  and  the  Collateral  Sciences 
published  several  communications  from  Davis,  and  one 
from  L.  Tucker,  at  that  time  President  of  the  Connec- 
ticut State  Society.  The  latter  definitely  suggested  for 
the  first  time  that  the  proposed  Convention  should  be  or- 
ganized on  a  permanent  basis  as  a  National  Medical  So- 
ciety. C.  A.  Lee,  the  editor  of  the  Journal,  strongly  sup- 
ported this  proposition.  Davis's  articles  on  the  subject 
were  at  times  almost  indiscreetly  vigorous  in  their  urging. 
He  criticised  severely  the  existing  state  of  medical  educa- 
tion, and  urged  especially  the  raising  of  the  standard  of 
preliminary  training;  the  importance  of  attaching  more 
weight  to  the  quality  of  private  teaching  given  by  prac- 
tising physicians  to  their  apprentices ;  a  higher  and  more 
uniform  standard  of  requirements  for  the  degree,  and  the 
devising  of  some  means  to  stimulate  the  ambition  of  the 
whole  profession  for  the  proper  and  continued  study  of 
science.  He  then  proceeded  to  urge,  as  the  necessary 
means  for  these  ends,  "  a  permanent  National  Society,  by 
whose   annual   discussions   an   exciting,    vivifying,    and 


AMERICAN    MEDICAL   ASSOCIATION.      435 

healthful  influence  shall  be  exerted  over  the  length  and 
breadth  of  the  country,  until  a  correct  and  noble  senti- 
ment is  engendered  in  the  bosom  of  every  member  of  the 
profession." 

All  this  talk  was  good  and  wholesome,  and  true  in  the 
main ;  but  it  stirred  up  enemies,  who  attacked  the  scheme 
as  a  whole  and  bitterly  assailed  the  author  thereof.  The 
most  conspicuous  and  aggressive  champion  of  this  oppo- 
sition was  Martyn  Paine,  a  professor  in  that  very  New 
York  School  which  had  offered  its  hall  for  the  Conven- 
tion. Paine's  attack  took  form  in  a  valedictory  address 
to  his  class  in  March,  1846,  some  two  months  before  the 
date  set  for  the  meeting.  He  called  his  address  "  A 
Defence  of  the  Medical  Profession  in  the  United  States." 
It  was  printed  and  widely  distributed  by  its  author,  and  is 
an  excellent  example  of  what  to  leave  unsaid  in  medico- 
political  discussions.  Indeed,  no  better  evidence  is  needed 
to  illustrate  the  low  esteem  in  which  conspicuous  edu- 
cators of  the  day  held  the  subject  of  medical  ethics. 

The  leading  thought  in  Paine's  thesis  was  based  on  the 
assumption  that  the  active  members  of  the  New  York 
State  Society,  and  Davis,  the  chairman  of  their  Commit- 
tee, in  particular,  had  been  slandering  and  defaming  the 
profession  to  which  they  belonged.  Here  is  a  paragraph 
which  illustrates  admirably  the  animus  of  the  man : 

"  It  is  not  the  man  who  has  officially  promulgated  the 
views  of  the  State  Medical  Society,  nor  the  journals 
through  which  the  contumelious  representation  of  the  pro- 
fession is  circulated,  that  should  be  held  responsible.  We 
must  rather  go  to  the  fountain-head  from  which  the  pur- 
pose emanates,  and  with  acids  and  caustics  try  its  purity. 
We  must  go  to  the  State  Medical  Society  itself,  interro- 
gate the  general  character  of  those  who  annually  convene 
at  Albany  during  the  very  opportune  session  of  the  Legis- 
lature, and  inquire  how  far  and  in  what  ways  they  contrib- 
ute to  the  dignity  of  the  profession  and  advance  the  inter- 


436  MEDICINE    IN    AMERICA. 

ests  of  medical  science.  Nor  would  I  invite  an  investigation 
of  this  nature  were  those  members  of  the  State  Medical  So- 
ciety who  annually  convene  at  Albany,  and  do  the  mining 
operations,  more  than  a  bare  handful  of  the  outs,  and  were 
they  not  so  erroneously  supposed  to  represent  the  voice 
of  the  profession.  ,  .  .  And  now,  perhaps,  we  shall  have 
no  difficulty  in  understanding  why  it  is  so  earnestly  de- 
sired to  extend  the  term  of  instruction  in  our  Medical 
Colleges,  and  also  as  a  preliminary  requisite  to  admission 
into  these  institutions.  There  is  an  aristocratic  feature 
in  this  movement  of  the  worst  omen,  however  the  spirit  by 
which  it  is  prompted  may  belong  to  the  agrarian  policy. 
It  is  oppression  towards  the  poor,  for  the  sake  of  crippling 
the  Medical  Colleges." 

The  writing  of  such  stuff  brought  the  fate  it  deserved, 
and  incidentally  served  to  illuminate  the  spirit  which  even 
the  greater  Schools  held  towards  each  other.  The  Penn- 
sylvania and  Jefferson  Schools  promptly  repudiated  the 
sentiments  of  Paine's  circular ;  and  Hewson,  of  Philadel- 
phia, wrote  to  the  committee  of  arrangements  stating  that 
they  had  hitherto  declined  joining  the  new  movement  be- 
cause the  Convention  had  been  called  to  meet  in  New 
York,  and  Philadelphians  had  concluded  that  this  was  a 
scheme  to  exploit  the  New  York  University  School.  Now 
they  were  undeceived  and  would  come  in. 

But  the  New  York  faculty  itself  was  influenced  by  such 
talk  as  Paine's,  and,  though  the  Convention  delegates 
were  to  meet  as  its  guests,  the  teaching  body  industriously 
opposed  the  purposes  of  the  gathering.  However,  the  in- 
vitations had  gone  out  and  the  day  was  set.  From  all 
parts  of  the  country  men  were  journeying  to  the  recep- 
tion of  their  ungracious  hosts,  and  on  Tuesday,  May  5, 
1846,  they  met,  to  the  number  of  about  one  hundred,  in 
the  hall  of  the  Medical  Department  of  the  New  York 
University. 

That  meeting  was  by  no  means  inharmonious.    Medical 


AMERICAN    MEDICAL   ASSOCIATION.      437 

representatives  were  present  from  the  various  places 
which  had  promised  representatives,  and  there  was  gen- 
eral rejoicing  among  those  who  had  travelled  from  dis- 
tant and  lonesome  parts  that  at  last  their  isolation  was  to 
be  broken  and  their  path  made  more  smooth.  The  occa- 
sion was  one  of  kindly  fraternizing  and  diligent  inter- 
change of  views.  They  promptly  proceeded  to  organize, 
and  elected  unanimously  a  number  of  excellent  representa- 
tive officers :  President,  the  veteran  Jonathan  Knight,  of 
New  Haven,  that  friend  and  colleague  of  Nathan  Smith ; 
Vice-Presidents,  John  Bell,  of  Philadelphia,  and  Edward 
Delafield,  of  New  York ;  Secretaries,  Richard  D.  Arnold, 
of  Savannah,  and  Alfred  Stille,  of  Philadelphia. 

So  far  all  was  very  smooth  and  pleasant.  The  new 
officers  were  conducted  to  their  chairs,  and  the  business  of 
the  meeting  was  about  to  be  resumed,  when  a  loud,  dis- 
cordant note  unexpectedly  was  sounded  from  the  irrecon- 
cilable faculty  of  the  New  York  University.  Gunning  S. 
Bedford  was  the  mouthpiece  of  these  gentlemen ;  he  was  a 
colleague  of  Paine  and  a  delegate  from  the  University; 
but  for  a  practical  American  he  showed  himself  remark- 
ably unskilled  in  political  manipulations.  He  rose  in  his 
place  in  the  Convention,  and,  after  some  blameless  re- 
marks on  the  value  of  such  gatherings,  moved  this  pream- 
ble and  resolution : 

"  Whereas^  The  call  of  the  State  Medical  Society  of 
New  York  for  a  National  Medical  Convention,  to  be  held 
in  the  City  of  New  York  on  the  first  Tuesday  in  May, 
has  failed  in  a  representation  from  one-half  of  the  United 
States,  and  from  a  majority  of  the  Medical  Colleges; 
and  whereas,  the  State  Medical  Society  has  emphatically 
stated  that  there  is  no  mode  of  accomplishing  the  object 
of  the  Convention  without  concert  of  action  on  the  part 
of  Medical  Societies,  Colleges,  and  Institutions  of  all  the 
States,  therefore, 

"  Resolved,  That  this  Convention  adjourn  sine  die." 


438  MEDICINE    IN    AMERICA. 

The  proposition  was  promptly  seconded  by  Bedford's 
colleague,  G.  S.  Pattison. 

That  was  the  one  dramatic  situation  of  the  occasion.  It 
is  hard  to  see  how  any  intelligent  man  could  seriously 
have  presented  so  fatuous  a  proposition.  The  insolence 
of  the  preamble  was  equalled  only  by  the  tactlessness  of 
the  resolution  itself.  It  was  a  cruel  slap  in  the  face  to 
the  crowd  of  eager,  generous  men  who,  at  great  sacrifice 
of  precious  time  and  effort,  had  gathered  there.  More- 
over, if  Bedford  had  seriously  expected  to  carry  his  au- 
dience with  him,  he  went  about  his  business  in  an  ignorant 
fashion.  He  had  done  no  canvassing ;  he  appears  to  have 
known  nothing  of  the  sentiments  and  wishes  of  his 
hearers,  but  thought,  apparently,  that  his  mere  ipse  dixit, 
coming  as  the  voice  of  the  New  York  faculty,  would  end 
the  matter. 

For  two  or  three  minutes  the  delegates  were  surprised 
into  silence;  then,  without  debate,  there  was  a  general  cry 
of  qnestion,  which  was  put  and  resulted  in  nays,  seventy- 
four;   yeas,  two, — Bedford  and  Pattison. 

Promptly  the  Convention  was  in  a  furor.  The  dele- 
gates were  righteously  indignant,  and.  after  speaking 
their  minds  to  the  gentlemen  of  the  minority,  w^ere  about 
to  withdraw  from  that  inhospitable  roof,  when  Bedford 
and  Pattison  recovered  themselves  and  made  abject  ex- 
planations and  apologies,  with  the  result  that  the  subject 
was  laid  on  the  table.  One  great  point  had  been  gained 
iDy  this  episode.  It  had  served  suddenly  to  crystallize 
sentiment  and  to  rouse  enthusiasm,  as  was  shown  soon 
afterwards  when  the  subject  of  making  the  Convention 
permanent  was  discussed. 

Harmony  having  been  restored,  members  got  to  work 
at  the  business  for  which  especially  they  had  been  sum- 
moned. A  committee  of  nine  was  appointed  to  formulate 
suggestions  regarding  the  subject  of  medical  education. 
They  straightway  agreed  upon  these  four  propositions : 


AMERICAN    MEDICAL   ASSOCIATION.     439 

First.  That  it  is  expedient  for  the  medical  profession 
of  the  United  States  to  institute  a  National  Medical  Asso- 
ciation. 

Second.  That  it  is  desirable  that  a  uniform  elevated 
standard  of  requirements  for  the  degree  of  M.D.  should 
be  adopted  by  all  the  Medical  Schools  in  the  United 
States. 

Third.  That  it  is  desirable  that  young  men  being  re- 
ceived as  students  of  medicine  should  have  acquired  a 
suitable  preliminary  education. 

Fourth.  That  it  is  expedient  that  the  medical  profes- 
sion in  the  United  States  should  be  governed  by  the  same 
code  of  medical  ethics. 

After  the  lapse  of  fifty-seven  years,  it  is  interesting  to 
observe  that  of  these  four  propositions,  on  which  the 
committee  quickly  agreed  without  dissent,  but  two — the 
first  and  the  third — have  commended  themselves  in  prac- 
tical form  to  the  profession  to-day. 

At  that  time,  however,  the  four  propositions  were  re- 
ferred to  appropriate  committees,  with  directions  to  report 
at  the  next  annual  meeting,  to  be  held  in  Philadelphia. 
Arrangements  were  also  made  for  the  more  clearly  set- 
ting forth  to  the  profession  of  the  country  the  need  and 
purposes  of  a  National  Association ;  besides,  on  the  urging 
of  Davis,  there  was  appointed  a  committee  to  consider 
and  report  upon  the  vexed  question  of  continuing  the 
teaching  and  licensing  in  the  hands  of  the  same  men. 
With  that  they  adjourned  to  meet  again  the  following 
year. 

The  success  of  that  first  New  York  Convention  assured 
the  success  of  the  National  Association.  To  forward  the 
plan,  an  excellent  representative  committee  had  been  ap- 
pointed,— John  Watson,  John  Stearns,  F.  Campbell  Stew- 
art, and  N.  S.  Davis,  of  New  York,  Alfred  Stille,  of 
Philadelphia,  W.  H.  Cogswell,  of  New  London,  and  E. 
D.  Fenner,  of  New  Orleans.    They  were  aided  in  propa- 


440  MEDICINE    IN   AMERICA. 

gating  the  faith  by  the  persuasive  pens  of  John  W.  Fran- 
cis, Samuel  Jackson,  S.  H.  Dickson,  and  various  others, 
while  the  voices  of  the  discontented  had  ceased  even  to 
growl  in  obscurity. 

The  year  passed  agreeably  and  profitably  in  such  pur- 
suits, and  on  May  5,  1847,  the  delegates  appointed  by  the 
Societies,  Colleges,  and  other  medical  bodies  throughout 
the  country  again  met,  this  time  in  the  hall  of  the  Acad- 
emy of  Natural  Sciences,  in  Philadelphia ;  and  again  or- 
ganized with  Knight  as  President  and  Stille  and  Stewart 
as  Secretaries. 

This  time  the  gathering  was  much  more  representa- 
tive than  the  year  before.  Two  hundred  and  fifty  dele- 
gates were  present  from  forty  Medical  Societies  and 
twenty-eight  Schools,  in  twenty-two  States  and  the  Dis- 
trict of  Columbia. 

The  most  important  work  of  this  Convention,  indeed 
the  work  on  which  hung  the  success  of  any  purposes  it 
might  have  in  view,  was  the  perfecting  of  a  permanent 
National  Association.  For  some  reason,  this  important 
step  was  not  taken  until  towards  the  end  of  the  meeting; 
but  at  last  that  question  was  reached  and  Watson's  com- 
mittee of  seven  made  its  report.  For  the  organization  of 
such  an  Association,  two  methods  were  possible.  The 
first,  a  Convention  or  Congress  on  a  basis  of  representa- 
tion, the  various  interested  Societies  and  Schools  fed- 
erating themselves  and  sending  delegates,  chosen  accord- 
ing to  a  fixed  ratio,  to  the  Convention.  The  second 
method  of  organizing,  and  a  much  less  democratic  one, 
was  to  make  the  Convention  self-perpetuating,  by  itself 
electing  members  into  its  own  body.  The  second,  or  un- 
democratic, method  was  proposed  by  Isaac  Hays,  of  Phil- 
adelphia, and  after  much  discussion  was  voted  down. 
Then  the  representation  scheme  proposed  by  Watson's 
committee  was  taken  up  and  adopted.  The  report  carried 
with  it  a  Constitution  for  the  Association.    In  the  pream- 


AMERICAN    MEDICAL   ASSOCIATION.     441 

ble  attached  to  the  Constitution  the  purposes  of  the  Asso- 
ciation were  declared  to  be  "  for  cultivating  and  ad- 
vancing medical  knowledge;  for  elevating  the  standard 
of  medical  education;  for  promoting  the  usefulness, 
honor,  and  interests  of  the  medical  profession;  for  en- 
lightening and  directing  public  opinion  in  regard  to  the 
duties,  responsibilities,  and  requirements  of  medical  men ; 
for  exciting  and  encouraging  emulation  and  concert  of 
action  in  the  profession,  and  for  facilitating  and  foster- 
ing friendly  intercourse  between  those  engaged  in  it." 

Inducements  were  held  out  for  the  forming  of  State 
and  County  Medical  Societies,  and  committees  were  sug- 
gested to  have  in  charge  the  discussion  of  the  various 
branches  of  medical  science. 

The  student  of  our  medical  politics  will  recognize  in  the 
two  schemes  referred  to  the  Convention  the  germs  of  two 
distinct  national  organizations,  both  of  which  were  des- 
tined to  come  into  very  active  and  important  being.  The 
American  Medical  Association  was  born  at  once  through 
the  adoption  of  Watson's  report,  and  has  continued  ever 
since  a  course  of  widening  importance  and  usefulness. 
Three  years  ago  the  Constitution  was  revised,  and  the  rep- 
resentation placed  at  a  greatly  higher  ratio,  so  as  to  accom- 
modate itself  to  the  expanded  country  and  the  larger 
number  of  affiliated  Societies.  The  plan  of  Hays,  after 
lying  fallow  for  a  time,  was  revived  in  the  next  genera- 
tion, with  the  resulting  formation  of  those  organizations 
known  collectively  to  us  as  the  Congress  of  American 
Physicians  and  Surgeons;  and  we  are  wont  to  believe 
that  for  both  associations  there  is  abundant  and  proper 
scope. 

At  that  Philadelphia  meeting  of  1847  there  were  va- 
rious other  topics  discussed  before  the  final  vote  came  on 
the  question  of  a  National  Association. 

John  H.  Griscom,  of  New  York,  made  a  report  from 


442  MEDICINE   IN    AMERICA. 

his  committee,  which  had  been  appointed  to  consider  the 
subject  of  procuring  from  the  State  governments  uniform 
and  efficient  laws  for  the  registration  of  births,  marriages, 
and  deaths;  and  to  propose  also  a  general  nomenclature 
of  diseases.  This  report  was  adopted,  and  is  to  be  found 
in  extenso  in  the  first  volume  of  the  Association's  Trans- 
actions. 

James  Couper,  of  Delaware,  made  a  report  on  "  Pre- 
liminary Education."  His  paper  embraced  resolutions 
affirming  the  advantages  of  a  knowledge  of  the  natural 
sciences  and  the  classics ;  recommending  physicians  to  ask 
from  their  pupils  a  higher  standard  in  such  studies,  and 
to  give  a  certificate  which  should  mean  something  not 
merely  perfunctory;  Medical  Colleges  were  urged  to  re- 
quire some  such  certificate  before  matriculating  students. 

This  was  all  very  moderate  indeed,  but,  such  as  it  was, 
it  was  passed  only  after  much  opposition. 

R.  W.  Haxall,  of  Virginia,  reported  on  requirements 
for  the  degree.  His  recommendations  are  mild  and  are 
recommendations  only,  but  show  that  the  profession  had 
distinctly  advanced  its  ideas  in  the  years  since  Morgan 
and  Rush  were  teaching.  The  resolutions  were  adopted 
in  the  following  form,  and  are  worth  reading : 

''  Resolved,  First,  that  it  be  recommended  to  all  the 
Colleges  to  lengthen  the  period  employed  in  lecturing  from 
four  to  six  months. 

"  Second,  That  no  student  shall  become  a  candidate  for 
tlie  degree  of  M.D.  unless  he  shall  have  devoted  three 
entire  years  to  the  study  of  medicine,  including  the  time 
allotted  to  attendance  on  the  lectures. 

"  Third,  That  the  candidate  shall  have  attended  two  full 
courses  of  lectures;  that  he  shall  be  twenty-one  years  of 
age,  and  in  all  cases  shall  produce  the  certificate  of  his 
preceptor,  to  prove  when  he  commenced  his  studies. 


AMERICAN    MEDICAL    ASSOCIATION.      443 

"  Fourth,  That  the  certificate  of  no  preceptor  shall  be 
received  who  is  avowedly  and  notoriously  an  irregular 
practitioner,  whether  he  shall  possess  the  degree  of  M.D. 
or  not. 

"  Fifth,  That  the  several  branches  of  medical  education 
already  named  in  this  report  (viz..  Theory  and  Practice 
of  Medicine,  Principles  and  Practice  of  Surgery,  General 
and  Special  Anatomy,  Midwifery,  and  Diseases  of 
Women  and  Children,  Chemistry  and  Medical  Jurispru- 
dence) be  taught  in  all  the  Colleges,  and  that  the  number 
of  professors  be  increased  to  seven. 

"  Sixth,  That  it  is  required  of  candidates  that  they  shall 
have  steadily  devoted  three  months  to  dissection. 

"  Seventh,  That  it  is  incumbent  upon  preceptors  to 
avail  themselves  of  every  opportunity  to  impart  clinical 
instruction  to  their  pupils,  and  upon  Medical  Colleges  to 
require  candidates  for  graduation  to  show  that  they  have 
attended  on  hospital  practice  for  one  session,  whenever  it 
can  be  accomplished,  for  the  advancement  of  the  same 
end. 

"  Eighth,  That  it  be  suggested  to  the  Faculties  of  the 
various  Medical  Institutions  of  the  country  to  adopt  some 
efficient  means  for  ascertaining  that  their  students  are 
actually  in  attendance  on  their  lectures. 

"  Ninth,  That  it  is  incumbent  on  all  Schools  and  Col- 
leges granting  diplomas  fully  to  carry  out  the  above  requi- 
sitions. 

"  Tenth,  That  it  is  considered  the  duty  of  preceptors  to 
advise  their  students  to  attend  only  such  institutions  as 
shall  rigidly  adhere  to  the  recommendations  herein  con- 
tained." 

These  resolutions  were  adopted  by  large  majorities; 
indeed,  the  only  clause  to  which  serious  objection  was 
made  was  that  first  one  extending  the  term  to  six  months. 
It  was  feared  that  students  could  not  be  held  for  so  long 
a  time ;  even  so,  the  clause  was  adopted. 


444  MEDICINE   IN   AMERICA. 

The  recommendations  were  accepted  as  the  views  of 
the  Association,  but  it  was  long  before  they  were  widely 
applied  in  the  Schools.  The  framers  thereof  were  wise 
men  with  a  long  lookout  ahead.  It  is  only  in  our  own 
generation  that  we  have  seen  their  plan  followed  and  ex- 
panded. 

A  report  on  Medical  Ethics  by  Bell  and  Hays  was 
adopted.  The  report  which  elicited  most  discussion,  and 
was  finally  referred  to  the  Committee  on  Medical  Educa- 
tion of  the  American  Medical  Association,  was  that  deal- 
ing with  the  question  of  the  licensing  and  teaching  being 
in  the  same  hands.  All  the  men  who  had  looked  into  the 
matter  agreed  that  the  existing  system  was  liable  to  great 
abuse,  and,  though  they  suggested  certain  specific  reme- 
dies, nothing  definite  was  accomplished. 

It  will  be  seen  that  the  result  of  all  this  talk  and  these 
resolutions  and  suggestions  was  in  the  line  of  increasing 
the  dignity  of  the  profession  by  raising  its  standards  and 
efficiency.  Such  was  the  object  for  which  primarily  the 
Association  was  formed. 

We  have  seen,  also,  how  the  last  work  of  the  Conven- 
tion was  to  resolve  itself  into  the  American  Medical  Asso- 
ciation. The  members  then  proceeded  to  elect  officers,  and 
agreed  to  meet  thereafter  annually  on  the  first  Tuesday  in 
May. 

The  first  officers  of  the  Association  were:  President, 
Nathaniel  Chapman,  of  Pennsylvania;  Vice-Presidents, 
Jonathan  Knight,  of  Connecticut,  Alexander  H.  Stevens, 
of  New  York,  James  Moultrie,  of  South  Carolina,  and  A, 
H.  Buchanan,  of  Tennessee;  Secretaries,  Alfred  Stille. 
of  Pennsylvania,  and  J.  R.  W.  Dunbar,  of  Maryland; 
Treasurer,  Isaac  Hays,  of  Pennsylvania. 

We  shall  not  follow  the  fortunes  of  the  Association 
through  the  years.  We  are  concerned  only  with  its  found- 
ing. The  dissensions  which  early  existed  were  soon 
healed.     The  Philadelphia  malcontents  came  in  in  1846, 


AMERICAN    MEDICAL   ASSOCIATION.     445 

and  in  the  first  year  of  the  Association's  life  Boston  men 
joined.  Hohnes  and  Bowditch  were  conspicuous,  and 
John  Collins  Warren  was  the  third  president. 

The  first  fifty  years  were  not  always  years  of  smooth 
sailing;  but  with  the  beginning  of  its  second  half-century 
the  Association  has  taken  on  renewed  vigor.  In  its  mem- 
bership, its  activity,  and  its  broad  democratic  spirit,  it  is 
promising  to  meet  the  fondest  hopes  of  its  wise  and  stren- 
uous founders. 


CHAPTER    XVI. 

THE  NINETEENTH   CENTURY.      NOTABLE  NAMES  OF  FIFTY 

YEARS. 

It  is  not  the  purpose  of  this  narrative,  as,  indeed,  it  is 
scarcely  within  the  bounds  of  reason,  to  discuss  at  length 
the  names  and  deeds  of  all  the  men  who  added  to  the  dis- 
tinction of  American  Medicine  during  the  first  half  of  the 
nineteenth  century.  Something,  and  in  halting  fashion, 
we  have  already  considered  of  some  of  the  best  of  them, 
and  that,  too,  at  the  risk  of  making  invidious  distinctions. 

If  this  were  a  ten-volume  history,  it  would  be  proper 
to  enter  upon  a  great  number  of  other  themes  connected 
with  our  art, — of  the  establishment  and  growth  of  schools, 
of  medical  journalism,  of  medical  legislation  and  juris- 
prudence, of  medical  libraries,  of  medical  heresies,  and  of 
other  topics  which  naturally  suggest  themselves  to  the  in- 
quiring mind.'  Such  matters  must  be  passed  over  by  this 
writer  for  the  present,  at  any  rate ;  but  it  seems  proper 
in  a  concluding  chapter  to  glance  hastily  over  the  names 
of  some  of  the  men  who  are  still  familiar  to  us,  and 
to  place  those  men,  by  a  brief  paragraph  or  two,  in  the 
positions  to  which  history  seems  to  be  assigning  them. 
Indeed,  this  has  already  been  done  by  the  able  quintette 
of  writers  who  contributed  to  "  A  Century  of  American 
Medicine."  ^ 

But  since  their  publishing  in  1876,  more  than  a  quarter 
of  a  century  has  elapsed,  and  already  a  truer  perspective 
is  ours  than  what  they  saw. 


'  Edward  H.  Clark,  Boston ;    Henry  J.  Bigelow,  Boston ;    Samuel 
D.  Gross,  Philadelphia ;    T.  Gaillard  Thomas,  New  York,  and  J.  S. 
Billings,  Washington. 
446 


XIX.  CENTURY.     NOTABLE    NAMES.       447 

In  point  of  time  the  earliest  memorable  man,  as  yet  un- 
named in  these  pages,  was  Felix  Pascalis  Ouviere,  com- 
monly known  under  the  name  of  Pascalis.  He  was  a 
Frenchman,  born  in  Provence  about  1 750,  and  a  graduate 
of  Montpellier.  He  went  to  St.  Domingo,  where  he  prac- 
tised until  driven  out  by  the  Revolution  of  1793.  Then 
he  came  to  America  and  lived  in  both  Philadelphia  and 
New  York  at  various  times.  So  we  find  him  associating 
with  such  of  our  friends  as  Rush,  Physick,  Hosack,  and 
Francis,  and  known  for  his  contributions  to  the  literature 
of  yellow  fever.  He  was  an  editor,  with  Miller,  Smith, 
and  Mitchell,  of  the  Medical  Repository,  and,  among  other 
interesting  papers,  contributed  one  on  syphilis,  which  was 
published  in  New  York  in  1812.  Pascalis  died,  an  old 
man,  in  that  city  in  1833. 

Wistar  is  a  name  famous  in  Philadelphia  for  more  than 
a  century,  and  Caspar  Wistar,  the  anatomist,  was  born 
there,  of  German  descent,  on  September  13,  1761.  He 
was  one  of  the  men  who  made  the  old  Pennsylvania 
School  a  hundred  years  ago.  Caspar  Morris,  his  biogra- 
pher, says  of  him  that,  both  as  a  cultivator  of  the  science 
and  a  practitioner  of  the  art  of  medicine,  Caspar  Wistar 
deserves  a  place  in  the  highest  rank  of  American  worthies. 

Wistar  dates  far  enough  back  to  have  been,  like  Rush, 
a  pupil  of  the  famous  John  Redman.  He  was  graduated 
Bachelor  of  Medicine  in  Philadelphia  in  1782,  twenty-one 
years  of  age, — older  than  most  of  the  young  graduates  of 
the  time ;  then  he  went  on  with  his  studies  in  Edinburgh, 
where  he  secured  the  doctor's  degree  in  1786.  On  leav- 
ing Edinburgh  he  returned  at  once  to  Philadelphia,  and 
was  made  Adjunct  Professor  of  Anatomy  in  1791 ;  Wil- 
liam Shippen,  Jr.,  continuing  to  hold  the  Professor's  chair. 
Wistar  taught  anatomy  until  his  death  in  1818.  During 
those  twenty-seven  years  he  became  a  very  distinguished 
personage  in  the  American  profession,  and  seems  to  have 
attracted  students  almost  as  strongly  as  did  Rush  in  his 


448  MEDICINE    IN    AMERICA. 

prime.  The  work  for  which  he  is  best  known  is  his  "  Sys- 
tem of  Anatomy,"  issued  in  parts  from  i8i  i  to  1814.  For 
many  years  it  was  a  standard  popular  text-book  for  stu- 
dents and  teachers. 

One  of  the  most  distinguished  and  useful  of  our  early 
American  surgeons  was  John  Beale  Davidge,  of  Mary- 
land. He  was  born  in  Annapolis  in  1769,  and  died  in 
Baltimore  in  1829. 

His  life  was  devoted  mainly  to  operative  surgery  and 
to  teaching,  and  he  is  chiefly  famous  as  one  of  the 
founders  of  the  University  of  Maryland,  where  he  held 
for  many  years  the  chair  of  Anatomy  and  Surgery.  As  a 
writer,  too,  he  became  well  known,  for  his  style  was  lucid 
and  convincing  and  his  themes  well  chosen.  Though  the 
author  of  no  great  work,  he  was  a  fairly  constant  con- 
tributor to  medical  journalism,  and  some  six  years  before 
his  death  established  a  publication,  now  but  little  known, 
The  Baltimore  Philosophical  Journal  and  Review.  Un- 
happily, but  one  number  was  published,  as  the  enterprise 
could  not  secure  proper  support. 

Another  Philadelphian,  famous  in  his  day  and  a  col- 
league of  Rush  and  Wistar,  though  much  younger  than 
either,  was  John  Redman  Coxe,  who  bore  the  name  of  a 
distinguished  physician.  Coxe  was  born  in  1773,  in  Colo- 
nial times,  and  lived  to  our  own  generation,  for  he  died 
during  the  Civil  War,  in  1864.  He  was  distinguished 
as  a  scholar  and  collector,  as  a  writer  and  a  chemist.  He 
was  born  in  Trenton,  New  Jersey,  of  well-to-do  parents, 
and  his  lines  were  always  smooth  enough,  it  appears.  His 
early  education  was  received  in  Edinburgh,  but  he  re- 
turned home  for  his  medical  studies,  and  entered  Rush's 
office,  attending  at  the  same  time  the  Pennsylvania  School, 
whence  he  was  graduated  in  1794.  Then  he  went  back  to 
Edinburgh  and  to  Paris  for  a  couple  of  years. 

In  1809,  some  thirteen  years  after  his  return  to  Phila- 
delphia to  begin  practice,  he  was  made  Professor  of  Chem- 


XIX.  CENTURY.     NOTABLE    NAMES.       449 

istry  in  the  School  there,  and  in  181 8  was  given  the  chair 
of  Materia  Medica  and  Pharmacy.  He  held  the  latter 
position  until  1835,  when  he  retired  at  the  age  of  sixty- 
two,  and  though  he  lived  nearly  thirty  years  longer, — ■ 
almost  equalling  his  old  pupil  Jacob  Bigelow  in  length  of 
years, — we  hear  of  him  in  the  scientific  world  no  more. 

In  1802,  soon  after  the  pioneer  work  of  Waterhouse, 
Coxe  published  "  Observations  on  Vaccination,"  his  most 
valuable  contribution  to  medical  literature. 

In  1806  and  1808  he  published  a  Dispensatory  and  a 
Medical  Dictionary,  very  creditable  and  useful  produc- 
tions for  the  time.  From  1804  to  181 1  he  edited  also  the 
Philadelphia  Medical  Museum,  the  second  regular  medi- 
cal journal  published  in  this  country-. 

But  Coxe  always  cared  more  for  the  ancients  than  the 
moderns.  He  collected  a  large  library  of  old  authors, — 
much  the  finest  of  its  day  in  America, — and  his  last  con- 
siderable work  was  the  one  which  satisfied  him  best,  "  The 
Writings  of  Hippocrates  and  Galen,"  which  was  published 
in  Philadelphia  in  1846. 

Take  him  all  in  all,  he  was  a  man  we  should  be  glad  to 
see  among  us  to-day, — a  scholar  in  medicine. 

An  interesting,  unfortunate,  and  in  some  ways  eminent 
physician  produced  by  Pennsylvania  was  John  Eberle, 
who  was  born  in  1788  and  died  in  1838.  Thomas  D. 
Mitchell  wrote  a  foolish  "  Life"  of  him,  and  Gross  pub- 
lished it  in  his  "  American  Medical  Biography."  Mitchell 
had  never  laid  to  heart  the  maxim  de  morfuis  nil  nisi 
honum,  and  out  of  his  sketch  it  is  difficult  to  extract  much 
of  good. 

One  conspicuous  fact,  however,  could  not  be  disguised, 
that  Eberle,  as  much  as  any  other  one  man,  was  the  pro- 
moter of  the  Jefferson  School,  founded  in  Philadelphia 
in  1826. 

He  came  of  the  old  German  peasant  stock  of  Pennsyl- 
vania, and  was  born  of  poor  parents.     In  some  way  they 

29 


450  MEDICINE    IN   AMERICA. 

were  able  to  educate  him,  and  he  was  graduated  a  Doctor 
of  Medicine  from  the  Pennsylvania  School  in  1809.  For 
many  years  after  that  he  neglected  his  profession  and, 
having  married,  supported  himself  by  newspaper  writing 
and  the  exigencies  of  petty  politics.  He  seemed  to  have 
become  a  victim  to  alcohol  and  opium  during  those  years 
and  to  have  gone  into  bankruptcy.  Finally,  in  18 19,  only 
nineteen  years  before  his  death,  he  took  up  practice  again 
and  that  career  which  made  him  famous.  He  settled  in 
Philadelphia,  became  well  and  favorably  known  to  the 
leading  men  of  the  profession,  and  when,  largely  by  his 
efforts,  the  Jefferson  School  was  established,  he  became 
its  Professor  of  the  Theory  and  Practice  of  Physic.  That 
position  he  held  for  six  years,  until  1831,  when,  by  the 
solicitation  of  Drake,  w^ho  had  been  his  colleague  for 
a  short  time,  he  went  out  to  Ohio,  to  take  a  chair  in  the 
projected  Miami  College.  This  organization  failed  to  ma- 
terialize, so  he  accepted  a  similar  position  in  the  Medical 
College  of  Ohio  in  Cincinnati.  Six  years  later,  in  1837, 
he  accepted  a  call  to  the  reorganized  Lexington  School, 
becoming  the  colleague  of  Dudley,  Richardson,  and 
Thomas  D.  Mitchell.  By  this  time,  however,  his  health 
was  gone,  and,  after  struggling  unsuccessfully  to  lecture, 
he  took  to  his  bed,  and  died  in  the  following  year. 

He  seems  to  have  been  an  attractive,  convincing  lec- 
turer. Great  things  were  expected  of  him  in  Lexington 
when  he  went  there  from  Cincinnati. 

Besides  teaching  and  promoting  medical  education, 
Eberle  published  in  1829  a  treatise  on  the  "  Practice  of 
Medicine,"  which  was  very  popular  among  the  students 
of  that  generation.  He  also  made  two  unsuccessful 
attempts  to  establish  medical  journals  in  Cincinnati.  The 
first,  The  Western  Medical  Gazette,  after  one  or  two  sus- 
pensions, ceased  with  the  second  volume  in  1835;  the 
second,  the  Western  Quarterly  Journal  of  Practical  Medi- 
cine, 1837,  did  not  get  beyond  the  first  number. 


XIX.  CEXTL'RY.     XOTAELE    NAMES.       451 

The  man  appears  to  have  been  fashioned  for  better 
things  than  he  accomphshed ;  but  certain  it  is  that  his 
doings  as  they  come  down  to  us  do  not  explain  that 
atmosphere  of  distinction  with  which  his  contemporaries 
seem  to  have  surrounded  him. 

Another  eminent  Pennsylvanian,  who  may  well  be 
called  the  Father  of  American  G}-naecolog}- — if  you  will 
pardon  the  absurdit}- — was  William  Potts  Dewees.  Born 
in  1768,  he  was  a  colleague  of  those  others  whom  this 
chapter  has  already  chronicled,  and  he  was  certainly  a 
strong  member  of  the  Pennsylvania  faculty-  for  many 
years. 

Thomas  says  of  him  that  his  genius  left  its  impress 
upon  American  obstetrics  more  decidedly  than  any  other 
has  done  before  or  since. 

He  was  a  man  of  decided  opinions,  of  considerable  elo- 
quence and  learning;  a  vigorous,  trenchant  writer,  and 
an  inspiring  teacher.  For  many  years  he  was  Professor 
of  Midwifery  in  the  Universit}*  of  Pennsylvania,  and  died 
in  Philadelphia  in  1841,  at  the  age  of  serventy-three.  after 
a  life  of  many  things  accomplished. 

As  with  so  many  other  physicians,  it  is  difficult  now  to 
estimate  the  extent  of  his  influence,  but  his  contemporaries 
and  pupils  proclaimed  him  a  great  man. 

As  a  writer  he  was  especially  successful.  In  1824  he 
published  a  "'  Comprehensive  System  of  Midwifery," 
which  ran  through  twelve  editions ;  in  1825.  a  "  Treatise 
on  the  Physical  and  Medical  Treatment  of  Children." 
which  reached  the  tenth  edition:  and  in  1826.  a 
"  Treatise  on  the  Diseases  of  Females."  which  also  went 
to  the  tenth  edition.  Surely  an  active  and  popular  pen. 
His  friend  and  pupil.  Hodge,  wrote  a  Memoir^  of  him, 
and  said  of  the  ''  INIidwifer}-"  that  it  "•'  takes  a  stand  de- 
cidedlv  in  advance  of  Denmon.  Osborne.  Bums,  and  even 


'American  Journal  of  the  Medical  Sciences.  Tanuar;.-.  1S43. 


452 


MEDICINE    IN    AMERICA. 


of  Baudelocque  himself."  Names  mostly  forgotten  by  us 
now,  but  leaving  us  to  infer  that  to  Dewees  our  medicine 
owes  a  very  heavy  debt. 

In  that  same  eighteenth  century,  three  years  after  the 
close  of  the  Revolution,  there  was  born  a  man  destined  to 
pass  most  of  his  life  as  an  army  surgeon,  but  known  in 
Europe  as  the  first  and  one  of  the  greatest  of  American 
physiologists.  William  Beaumont,  a  name  inseparably 
connected  by  students  with  that  of  Alexis  St.  Martin,  the 
simple  Canadian  voyageur,  was  born  in  1785  and  died  in 

1853- 

Not  long  ago  Osier  ^  told  about  him,  in  his  inimitable 

fashion,  and  brought  him  out  of  the  obscurity  into  which 
we  practical  moderns  had  been  allowing  him  to  drift. 

Beaumont's  father  was  a  prosperous  farmer  of  Leb- 
anon, Connecticut,  and  a  Jeffersonian  Democrat.  In  1807, 
at  the  age  of  twenty-two,  young  Beaumont  set  out  to  seek 
his  fortune,  and,  drifting  to  the  village  of  Champlain, 
New  York,  soon  became  a  popular  and  respected  school- 
master. He  became  interested  in  medicine,  and  with  the 
help  of  two  neighboring  doctors — Seth  Pomeroy  and  Ben- 
jamin Chandler — took  up  the  study  of  their  profession, 
which,  with  various  desultory  practice,  occupied  him  until 
the  outbreak  of  the  War  of  1812.  Then  he  applied  for  a 
staff  position  in  the  regular  army,  and  was  appointed 
assistant-surgeon  to  the  Sixth  Infantry.  He  saw  a  variety 
of  fighting  during  the  following  years,  and  was  present 
at  many  of  those  petty  engagements  which  took  place 
along  the  Canadian  border  from  Niagara  to  Lake  Cham- 
plain.  After  the  war  Beaumont  resigned  his  commission 
and  practised  very  successfully  in  Plattsburg,  New  York, 
for  five  years,  when  he  again  applied  for  an  army  posi- 


^  The  Journal  of  the  American  Medical  Association,  vol.  xxxix.  p. 
1223,  1902. 


XIX.  CENTURY.     NOTABLE    NAMES.       453 

tion,  and  in  1820  was  given  a  surgeoncy  and  assigned  to 
the  post  of  Fort  Mackinac  at  the  Straits  of  Mackinac  in 
northern  Michigan.  Two  years  later,  while  holding  this 
obscure  position,  he  came  into  the  possession  of  Alexis  St. 
Martin,  the  subject  of  his  "  Experiments  on  the  Gastric 
Juice,"  as  he  himself  so  graphically  tells  in  the  introduc- 
tion to  his  famous  book.  The  coming  into  possession  fell 
on  this  wise :  On  the  morning  of  the  6th  of  June,  1822,  St. 
Martin,  a  French  Canadian  lad,  was  standing  in  the  com- 
pany's store,  "  where  one  of  the  party  was  holding  a  shot- 
gun (not  a  musket),  which  was  accidentally  discharged, 
the  whole  charge  entering  St.  Martin's  body.  The  muzzle 
was  not  over  three  feet  from  him, — I  think  not  more  than 
two.  The  wadding  entered  as  well  as  pieces  of  his  cloth- 
ing; his  shirt  took  fire;  he  fell,  as  we  supposed,  dead."  ■* 
The  wound  was  just  under  the  left  breast  at  the  costal 
margin ;  the  pleural  and  abdominal  cavities  were  opened ; 
the  diaphragm  was  lacerated  and  the  stomach  perforated, 
allowing  the  escape  of  the  gastric  contents.  Of  course, 
the  patient's  life  was  despaired  of,  and,  when  Beaumont 
arrived  on  the  scene  a  few  minutes  later,  he  dressed  the 
wound  for  decency's  sake,  expecting  to  learn  of  the  man's 
death  when  he  should  return  a  couple  of  hours  later.  But 
the  man  did  not  die.  Beaumont  gives  a  detailed  account 
of  his  convalescence,  which  lasted  nearly  three  years. 
Portions  of  ribs  exfoliated  and  came  away,  abscesses  de- 
veloped, discharged,  and  closed,  and  the  stomach  became 
adherent  to  the  anterior  abdominal  wall,  with  the  forma- 
tion of  a  fistulous  track  leading  to  it;  the  opening  being 
closed  by  a  valve-like  flap  of  mucous  membrane.  Finally, 
the  man  regained  entirely  his  health  and  strength,  and  in 
May,  1825,  entering  into  the  service  of  Beaumont,  be- 
came the   subject   of   the   latter's   experimental   studies. 


*  Statement  of  G.  G.  Hubbard,  an  officer  of  the  company :    quoted 
by  J.  R.  Bally  and  Osier. 


454 


MEDICINE   IN   AMERICA. 


Those  studies  of  Beaumont  occupied  about  three  years  in 
all,  and  were  made  at  various  periods  between  1825  and 
1833.  After  that  St.  Martin  got  back  into  Canada,  and, 
though  he  travelled  about  exhibiting  himself  at  sundry 
times  and  was  entreated  for  many  years  to  submit  himself 
to  further  experimentation,  he  never  again  came  under 
the  observation  of  his  benefactor. 

The  work  which  Beaumont  did  and  the  book  he  pub- 
lished admit  of  no  analysis  here;  for  is  not  their  im- 
mense value  to  science  familiar  to  all  students  ?  The  book 
itself,  an  octavo  of  two  hundred  and  eighty  pages,  is  en- 
titled "  Experiments  and  Observations  on  the  Gastric 
Juice  and  the  Physiology  of  Digestion,"  by  William  Beau- 
mont, Surgeon  to  the  United  States  Army,  Plattsburg. 
Printed  by  F.  P.  Allen,  1833. 

In  1838  the  book  was  repubhshed  in  Edinburgh  under 
the  editorship  of  Andrew  Combe,  whose  admirable  intro- 
duction tells  us  how  the  work  was  viewed  by  foreign  scien- 
tists. "  It  would  be  difficult  to  point  out  any  observer 
who  excels  him  (Beaumont)  in  devotion  to  truth  and 
freedom  from  the  trammels  of  theory  and  prejudice.  He 
tells  plainly  what  he  saw,  and  leaves  every  one  to  draw 
his  own  inferences;  or,  where  he  lays  down  conclusions, 
he  does  so  with  a  degree  of  modesty  and  fairness  of 
which  few  perhaps  in  his  circumstances  would  have  been 
capable." 

In  1839,  six  years  after  the  publication  of  the  first  edi- 
tion of  his  book,  Beaumont  resigned  from  the  army.  He 
happened  to  be  stationed  in  St.  Louis  at  the  time,  and 
there  he  settled  down  as  a  general  practitioner.  His 
vigor,  his  ability,  his  unusual  attainments,  and  his  enthu- 
siasm for  his  work  quickly  drew  to  him  a  large  and  lucra- 
tive practice,  and,  though  he  was  fifty-four  years  old 
when  he  took  up  this  new  career,  he  distanced  his  juniors 
and  soon  became  recognized  as  one  of  the  leading  men  of 
the  city.    As  the  town  grew,  he  grew  with  it,  and  to  the 


XIX.  CENTURY.    NOTABLE   NAMES. 


455 


end  of  his  busy  life  he  seems  always  to  have  been  happy, 
prosperous,  and  fortunate. 

He  died  April  25,  1853,  in  his  sixty-ninth  year.  As 
has  been  well  said  of  him,  he  is  the  pioneer  physiologist 
of  this  country,  the  first  to  make  an  important  and  endur- 
ing contribution  to  this  science. 

There  were  several  New  York  surgeons  who  flourished 
in  the  first  half  of  the  last  century,  distinguished  men  in 
their  day,  friends  and  contemporaries  of  Mott.  Four  of 
them  are  especially  to  be  mentioned,  Kissam,  Rogers, 
Stevens,  and  Watson. 

Richard  S.  Kissam  has  been  already  named.  He  was 
an  amiable  man,  an  able  and  competent  operator;  not 
especially  to  be  noticed,  except  that  his  name  appears 
frequently  in  the  medical  literature  of  the  time.  Ninety 
years  ago  he  was  a  landmark,  well  known  to  the  quaint 
old  town,  and  the  laity  spoke  of  him  fearfully  and  re- 
spectfully as  the  man  who  had  operated  on  sixty-five 
cases  of  stone  in  the  bladder,  with  but  three  deaths.  He 
died  in  1822. 

Then  there  was  J.  Kearney  Rogers,  who  was  born  in 
New  York  in  1793  and  died  in  1857.  A  fine,  popular  type 
of  man,  abundantly  educated  according  to  the  best  stand- 
ards of  the  time, — a  pupil  of  Wright  Post,  Astley  Cooper, 
Abernethy,  and  Brodie.  With  Edward  Delafield,  he 
founded  the  New  York  Eye  and  Ear  Infirmary,  and  was 
famous  for  his  surgical  technique  and  brilliant  operating. 
His  chief  claim  to  fame  among  surgeons  was  won  in  1846, 
when  he  tied  the  subclavian  artery  between  the  scalene 
muscles  for  aneurism. 

Contemporary  with  Rogers  was  Alexander  H.  Stevens, 
who  was  born  in  1789  and  died  in  1869.  He,  too,  was 
a  famous  old  landmark,  and  seventy-  five  years  ago  was 
a  popular  surgical  teacher  and  professor  of  surgery.  In 
early  life  he  made  a  name  for  himself  by  the  publication 
of  a  translation  of  Boyer's  treatise  on  "  Surgery,"  and 


456  MEDICINE    IN    AMERICA. 

later  he  wrote  several  valuable  surgical  memoirs.  For 
many  years  before  his  death  he  lived  in  retirement  at 
Astoria,  Long  Island. 

John  Watson  was  the  youngest  of  this  group  of  sur- 
geons, but  by  no  means  the  least  distinguished.  He  was 
an  Irishman,  born  in  Londonderry  in  1807,  who  came  to 
New  York  as  a  child.  He  was  an  able,  brilliant  operator, 
as  were  so  many  of  those;  but  he  was  also  a  sound 
scholar,  an  admirable  critic,  and  a  delightful  writer.  For 
many  years,  too,  he  conducted  a  wide  practice, — a  general 
practice,  such  as  fell  to  the  lot  of  all  the  surgeons  in  this 
country  in  those  days,  and  most  admirable  general  practi- 
tioners they  were. 

In  1856  Watson  published  his  "  Medical  Profession  in 
Ancient  Times,"  an  interesting  book,  full  of  information, 
which  one  may  read  and  remember.  His  library,  at  the 
time  of  his  death  shortly  afterwards,  was  one  of  the 
largest  collections  of  the  works  of  the  fathers  to  be  found 
in  this  country. 

Another  interesting  group  belonging  to  the  same  gen- 
eration was  that  of  the  three  brothers  Beck,  New  York 
men.  Born  in  Schenectady,  their  lives  were  passed  be- 
tween that  town,  Albany,  and  New  York  City. 

The  eldest,  Theodoric  Romeyn  Beck,  was  born  in  1791, 
graduated  in  arts  at  Union  College,  of  which  his  maternal 
grandfather  had  been  the  distinguished  promoter,  studied 
medicine  with  Hosack,  and  received  his  doctor's  degree 
from  the  College  of  Physicians  and  Surgeons  in  181 1. 
Four  years  later  he  was  called  to  be  a  teacher  in  the  Medi- 
cal School  at  Fairfield,  where  he  held  the  chair  of  Medi- 
cine and  Medical  Jurisprudence. 

From  that  time  he  was  always  teaching ;  indeed,  he  was 
the  first  American  doctor  of  any  distinction  who  gave  up 
the  practice  of  medicine  in  order  to  devote  himself  to  that 
branch  of  professional  work.  The  Fairfield  a])])ointment 
was  not  so.  obscure  as  it  sounds.     The  School  was  in 


XIX.  CENTURY.     NOTABLE    NAMES.       457 

reality  the  department  of  the  College  of  Physicians  and 
Surgeons  for  the  Western  District,  in  Herkimer  County, 
New  York,  and  was  established  under  the  auspices  of  the 
Regents.  In  1817  T.  R.  Beck  retired  definitely  from  a  prac- 
tice which  he  abominated  and  adorned.  At  the  same  time 
he  accepted  the  position  of  Principal  of  the  Albany  Acad- 
emy, and  kept  up  his  work  at  Fairfield,  which  occupied 
but  a  small  part  of  each  year.  The  school  teaching  did 
not  last  very  long,  but  he  went  on  at  Fairfield  until  the 
College  was  abolished  in  1840.  Albany  and  Geneva  had 
medical  schools,  more  than  enough  for  central  New  York 
then.  After  that  Beck  took  the  chair  of  Materia  Medica 
in  the  Albany  Medical  College  and  held  it  until  1854,  the 
year  before  his  death. 

T.  R.  Beck  published  a  really  great  work,  a  treatise  on 
"  Medical  Jurisprudence,"  which  appeared  in  1823,  in 
two  volumes.  Ten  editions  were  issued  during  the  au- 
thor's life,  including  four  English  editions.  This  was  the 
magnum  opus  which  occupied  his  best  years  and  his  best 
thought.  It  soon  won  a  world-wide  reputation,  and  of 
the  author  and  his  volumes  a  writer  says,  "  To  him 
(Beck)  is  certainly  due  the  high  credit  not  merely  of 
rousing  public  attention  to  an  important  and  neglected 
subject,  but  also  of  presenting  a  work  upon  it  which  will 
probably  never  be  entirely  superseded.  In  foreign  coun- 
tries its  merits  have  been  duly  appreciated  and  magnani- 
mously acknowledged;"  and  the  Edinburgh  Medical  and 
Surgical  Journal  says  (vol.  xxii.  page  179)  : 

"  At  length,  however,  the  English  language  may  boast 
of  a  general  work  on  Medical  Jurisprudence  which  will 
not  only  stand  comparison  with  the  best  of  the  kind  that 
the  Continent  has  produced,  but  which  may  also  be  re- 
ferred to  by  every  medical  jurist  as  a  monument  worthy 
of  his  science,  and  as  a  criterion  by  which  he  is  willing  that 
its  interest  and  utility  should  be  tried." 

Theodoric  Romeyn  Beck  died  on  November  19,  1855. 


458  MEDICINE   IN    AMERICA. 

John  Broadhead  Beck  was  the  second  of  the  distin- 
guished brothers,  and  was  born  at  Schenectady  on  Sep- 
tember 1 8,  1794.  The  father  of  these  men  died  at  the 
age  of  twenty-seven,  while  they  were  all  children,  so  that 
they  naturally  drifted  apart  in  early  life,  John  B.  Beck 
was  graduated  from  Columbia  in  1813 ;  then  travelled  and 
studied  in  Europe,  and  returned  to  New  York  to  take  up 
medicine.  He  entered  the  office  of  Hosack,  and  suc- 
ceeded to  the  position  of  his  immediate  predecessor,  Fran- 
cis. In  181 7  he  was  graduated  from  the  College  of 
Physicians  and  Surgeons,  and  presented  a  thesis  on  Infan- 
ticide, a  treatise  which  is  still  valuable.  His  brother  Theo- 
doric  Romeyn  incorporated  it  into  his  work  on  Medical 
Jurisprudence.  In  1822,  together  with  Francis  and  Dyck- 
man.  Beck  established  the  Nezv  York  Medical  and  Physi- 
cal Journal,  to  which  he  contributed  many  valuable  papers, 
notably  on  laryngitis  and  yellow  fever. 

In  1826  came  an  interesting  episode.  John  B.  Beck 
was  elected  Professor  of  Materia  Medica  and  Botany  in 
the  newly  organized  College  of  Physicians  and  Surgeons, 
— newly  organized  because  of  the  recent  resignation  of  the 
old  faculty.  Post,  Hosack,  Mitchell,  Mott,  McNeven,  and 
Francis.  In  the  acute  controversies  which  followed.  Beck 
took  his  full  share,  and  for  a  time  was  completel}^ 
estranged  from  his  old  friends,  who  proceeded  at  once  to 
organize  that  Rutgers  Medical  College  of  which  we  have 
heard.  He  himself  continued  a  teacher  in  the  old  school 
for  many  years,  and  was  a  physician  to  the  New  York 
Hospital.  As  teacher  and  practitioner  he  was  popular 
and  useful. 

He  was  a  writer,  too.  You  should  read  his  "  Historical 
Sketch  of  the  State  of  Medicine  in  the  American  Colo- 
nies." Up  to  the  time  of  its  publication,  no  other  similar 
work  liad  been  done  so  accurately.  They  came  to  call  him 
"  the  Learned  Beck"  for  his  researches;  and  he  wrote  and 
published  also  "  Essays  on  Infant  Therapeutics,"  "  Lee- 


XIX.  CENTURY.     NOTABLE    NAMES.       459 

tures  on  Materia  Medica,"  and  "  Researches  in  Medicine 
and  Medical  Jurisprudence."  He  died  while  occupied 
with  such  things,  in  1851. 

Lewis  C.  Beck  was  a  younger  brother  of  the  two  others. 
He  was  born  in  1798  and  died  in  1853.  Though  four 
years  junior  to  John,  he  was  admitted  to  practice  in 
1 818,  one  year  later  than  his  elder.  He,  too,  was  inter- 
ested always  in  medicine  rather  than  surgery,  and  espe- 
cially in  the  teaching  side  of  the  life.  From  1826  to  1832 
he  was  Professor  of  Botany  and  Chemistry  in  the  Ver- 
mont Academy  of  Medicine,  where  he  came  in  contact 
with  Nathan  Smith.  In  1836  he  was  appointed  Mineralo- 
gist to  the  Geological  Survey  of  the  State  of  New  York, 
and  in  1840  was  elected  Professor  of  Chemistry  and  Phar- 
macy in  the  Albany  Medical  College.  He  was  a  prolific 
writer  on  the  scientific  subjects  which  he  professed,  his 
most  important  work  being  a  "  Report  on  Cholera,"  made 
to  the  Governor  of  New  York  in  1832. 

Franklin  Bache,  of  Philadelphia,  is  to  be  named.  He 
was  born  in  1792  and  died  in  1864.  For  many  years  he 
was  Professor  of  Chemistry  in  the  Jefferson  Medical  Col- 
lege of  Philadelphia.  He  is  to  be  named  because  of  the 
"  Dispensatory  of  the  United  States,"  which  with  George 
B.  Wood  he  compiled.  The  first  edition  was  issued  in 
1833  and  the  seventh  in  1847.  The  work  was  encyclo- 
paedic and  of  very  great  importance. 

Charles  D.  Meigs  was  born  in  Bermuda  in  1792,  and 
began  practice  in  Philadelphia  in  181 5.  Of  him  a  re- 
viewer^ has  unkindly  written:  "The  literary  works  of 
Dr.  Meigs  compare  very  unfavorably  with  those  of  his 
rival  (Hodge)  as  to  scientific  value  and  exactness,  but 
they  are  much  more  attractive  to  students  and  those  who 
read  for  pleasure  rather  than  instruction." 

Meigs  was  a  candidate  for  the  chair  of  Obstetrics  in 


'J.  S.  Billings,  1876. 


46o  MEDICINE    IN    AMERICA. 

the  University  of  Pennsylvania  in  1835,  but  was  passed 
over  for  Hodge.  In  1841  he  obtained  the  corresponding 
position  in  the  Jefferson  School.  His  best-known  publi- 
cations were  "Woman;  her  Diseases  and  Remedies" 
(1847)  J  "  Obstetrics,  the  Science  and  Art"  (1849)  5  ^ 
"  Treatise  on  Acute  and  Chronic  Diseases  of  the  Neck  of 
the  Uterus"  (1850),  and  "On  the  Nature,  Signs,  and 
Treatment  of  Childbed  Fevers"  ( 1854). 

Meigs  drew  special  attention  to  cardiac  thrombosis  as 
a  cause  of  those  sudden  deaths  which  occur  in  childbed; 
those  deaths  which  had  generally  been  attributed  to  "  syn- 
cope." In  this  connection,  T.  Gaillard  Thomas  has  writ- 
ten a  paragraph  which  must  interest  every  American  stu- 
dent of  the  history  of  Medicine. 

"  It  has  been  remarked  by  an  eminent  American  author 
that  Meigs  '  just  escaped  the  honor  which  is  now  and  will 
hereafter  be  given  to  the  eminent  Virchow,  of  Berlin,  of 
a  great  pathological  discovery.'  Even  admitting  the  truth 
of  this  statement,  it  is  certainly  well  that  the  justice  of  the 
award  should  here  be  questioned.  Meigs  proclaimed  the 
fact  in  no  uncertain  or  wavering  tones,  but  boldly,  de- 
cidedly, repeatedly,  and  by  every  method.  Why  is  the 
honor  not  his  ?  What  else  could  he  have  done  to  deserve 
it?  Many  of  his  countrymen  will  sympathize  with  the 
voice  which  speaks  now,  after  death,  in  this  unmistakable 
manner,  '  I  have  a  just  right  to  claim  the  merit  of  being 
the  first  writer  to  call  the  attention  of  the  medical  pro- 
fession to  these  sudden  concretions  of  these  concrescible 
elements  of  the  blood  in  the  heart  and  great  vessels.'  It 
may  be  said  that  he  did  not  follow  his  discovery  into  de- 
tail as  regarded  secondary  deposits  of  emboli.  What  of 
that  ?  He  does  not  claim  to  have  done  so.  What  he  does 
claim  is  clearly  and  unquestionably  claimed  with  justice." 

Meigs  died  on  June  22,  1869. 

Virginia  and  the  eighteenth  century  furnished  to  Phila- 
delphia many  eminent  physicians,   few  of  them   better 


XIX.  CENTURY.     NOTABLE    NAMES.       461 

worthy  of  record  than  John  K.  Mitchell,  who  was  born 
in  1793. 

Mitchell  was  graduated  in  Arts  at  Edinburgh  in  181 5, 
and  coming  then  to  Philadelphia  studied  under  Chapman 
and  at  the  Pennsylvania  School,  where  he  took  his  degree 
in  medicine  in  181 9.  After  that  he  spent  a  couple  of  years 
in  voyaging  for  his  health  to  India,  China,  and  other  dis- 
tant parts.  Finally,  in  1822  he  settled  down  to  practice 
in  Philadelphia  and  to  give  lectures  on  Medical  Chemistry 
in  the  Summer  School  there.  In  1841,  at  the  age  of 
forty-eight,  he  was  made  Professor  of  the  Practice  of 
Medicine  in  the  Jefferson  School,  and  there  he  taught 
until  his  death  in  1858.  He  is  worthy  of  record  because 
he  was  a  patient,  original  investigator,  and  a  clear,  logical 
reasoner.  His  essays  on  the  "  Cryptogamous  Origin  of 
Fevers,"  on  "  Mesmerism,"  "  Endosmosis,"  and  the 
"  Ligature  of  Limbs  for  Spasm"  are  full  of  keen  observa- 
tions and  thoughtful  hypotheses. 

A  medical  genius  of  ours,  dead  before  his  prime,  was 
John  D.  Godman,  who  was  born  in  Annapolis  in  1794  and 
died  in  Philadelphia  in  1830,  at  the  age  of  thirty-six. 

Doubtless  he  was  no  Bichat,  but  he  was  a  young  man  of 
much  the  same  enthusiasm  and  soundness  of  mind.  He 
was  poor  and  without  friends,  but  an  insatiable  thirst  for 
knowledge  urged  him  to  secure  an  education.  In  18 18, 
when  twenty-four  years  old,  he  was  graduated  from  the 
Medical  Department  of  the  University  of  Maryland. 
Three  years  later  he  went  to  Cincinnati,  to  the  chair  of 
Anatomy  of  the  unhappy  Medical  College  of  Ohio;  but 
the  state  of  chronic  despair  there  prevailing  and  the  dis- 
sensions of  the  faculty  soon  brought  about  his  resigna- 
tion. Then  he  started  the  first  medical  journal  west  of 
the  Alleghanies,  the  Western  Quarterly  Reporter  of  Med- 
ical, Surgical,  and  Natural  Science.  The  enterprise 
struggled  on  so  far  as  number  three  of  the  second  volume, 
when  Godman  abandoned  the  Western  field,  and  in  1822 


462  MEDICINE    IN    AMERICA. 

went  to  Philadelphia  to  practise  medicine  and  establish  a 
private  course  in  anatomy.  Though  his  health  was  fail- 
ing, he  pushed  on,  and  in  1826  had  made  himself  so  con- 
spicuous as  a  scientist  that  he  was  called  to  the  chair  of 
Anatomy  at  Rutgers,  in  New  York,  to  meet  there  the 
goodly  company  of  distinguished  men  so  often  named. 
Mott  took  a  special  liking  to  him,  and  was  deeply  dis- 
tressed the  following  year  when  he  broke  down  and  had  to 
give  up  teaching.  Godman  continued  to  write,  however, 
during  the  three  years  which  remained  to  him.  His 
treatises  on  the  "  Fascia"  and  "  Physiological  and  Patho- 
logical Anatomy,"  produced  during  those  painful  years, 
were  his  most  valuable  contributions  to  science. 

Rene  la  Roche  was  an  eminent  writer  on  Yellow  Fever, 
who  published  in  1855.  He  was  of  French  descent,  but 
was  born  in  Philadelphia  in  1795,  his  father  being  an 
emigrant  from  St.  Domingo.  La  Roche  was  not  con- 
nected with  any  medical  school.  His  reputation  rests  on 
his  writings,  and  especially  on  that  yellow  fever  treatise, 
which  embodies,  corrects,  and  amplifies  practically  all  that 
was  known  of  the  disease  up  to  the  time  of  its  publica- 
tion.   It  was  for  long  regarded  as  a  classic. 

George  McClellan  shares  the  honor  with  sundry  others, 
notably,  Eberle,  Rhees,  Green,  and  Beattie,  of  being  called 
the  founder  of  the  Jefferson  Medical  College.  He  was 
born  at  Woodstock,  Connecticut,  in  1796,  and  died  in 
1847,  in  the  fifty-first  year  of  his  age.  He  made  no  great 
permanent  impression  upon  our  art,  except  that  he  helped 
to  launch  a  new  school ;  but  he  was  extremely  popular  in 
his  time  as  a  bold,  dashing  operator,  and  an  enthusiastic, 
inspiring  teacher.  His  book,  "  The  Principles  and  Prac- 
tice of  Surgery,"  was  edited,  as  a  posthumous  work,  by  his 
son,  John  H.  B.  McClellan. 

Robley  Dunglison,  an  enterprising  Englishman,  was 
for  years  one  of  our  most  fertile  and  prolific  medical 
teachers  and  writers.     He  was  born  in  Keswick  in  1798, 


XIX.  CENTURY.     NOTABLE    NAMES.       463 

and  was  well  educated  at  Edinburgh,  London,  and  Paris. 
Then  he  settled  down  in  London  to  practise  and  write.  In 
1824,  when  twenty-six  years  old,  he  published  a  treatise 
on  "  Children's  Diseases;"  at  the  same  time  he  was  an 
editor  of  the  London  Medical  Repository.  In  that  year 
Thomas  Jefferson  was  at  work  developing  the  University 
of  Virginia.  The  old  man  seems  to  have  been  unable  to 
find  in  America  material  suitable  and  willing  for  the  staff 
of  the  Medical  School.  He  wanted  a  man  for  the  com- 
prehensive chair  of  Anatomy,  Physiology,  Materia  Med- 
ica,  and  Pharmacy;  so  he  looked  to  England,  and  fixed 
upon  young  Dunglison  in  London,  who  gladly  accepted 
the  call.  That  was  the  Dunglison  who  wrote  the  "  Dic- 
tionary." Every  doctor  over  thirty-five  years  old  owns  a 
copy  of  it.  And  that  was  the  Robley  Dunglison,  too,  who 
made  himself  so  popular  in  America  that  people  took  to 
naming  their  children  after  him.  Old  Dr.  Evans,  of  Vir- 
ginia, did  so,  as  the  Navy  Department  knows. 

So  Dunglison  came  out  to  Virginia  in  1824  and  stayed 
there  until  1833.  During  those  nine  years,  in  1827,  he 
published  a  syllabus  of  his  course  in  Medical  Jurispru- 
dence, and  prepared  his  "  Medical  Dictionary." 

By  the  year  1833  the  man's  reputation  had  been  spread 
broadcast,  so  that  they  called  him  to  a  wider  field  in  Balti- 
more. He  became  Professor  of  Materia  Medica,  Thera- 
peutics, Hygiene,  and  Medical  Jurisprudence  in  the  Uni- 
versity of  Maryland.  Three  years  more  brought  him  to 
Philadelphia  and  the  Jefferson  School,  which  was  busy 
looking  about  for  rising  stars.  In  1836  he  took  the  chair 
of  Medicine  there,  and  remained  until  1868,  the  year  be- 
fore his  death.  He  was  an  interesting  and  thorough 
teacher,  and  he  published  sundry  books.  His  "  System 
of  Physiology"  (first  edition,  1832)  ;  "  Hygiene"  (first 
edition,  1835);  "Therapeutics"  (1836);  "Practice" 
(1842),  and  "  Materia  Medica"  (1843)  were  well  known, 
and  passed  through  several  editions. 


464  MEDICINE    IN   AMERICA. 

Of  course,  his  admirable  "  Medical  Dictionary"  was  his 
monumental  work  and  made  him  deservedly  famous.  The 
first  edition  was  published  in  Boston  in  1833,  in  two  vol- 
umes. It  contains  short  sketches  of  prominent  physicians. 
Unfortunately,  those  little  biographies  were  not  reprinted 
in  the  subsequent  editions. 

Dunglison  died  on  April  i,  1869. 

The  name  of  Hugh  L.  Hodge  has  been  familiar  to 
American  students  of  medicine  for  three  generations.  He 
was  born  in  1796,  was  graduated  in  Arts  from  Princeton, 
in  Medicine  from  the  University  of  Pennsylvania,  and 
was  a  private  pupil  of  Caspar  Wistar,  from  whom  he 
received  a  strong  taste  for  surgery.  However,  after  set- 
tling to  practice  in  Philadelphia,  he  fell  under  the  influence 
of  Dewees,  who  induced  him  to  devote  himself  to  mid- 
wifery and  the  diseases  of  women.  In  those  specialties 
he  became  famous  as  practitioner,  lecturer,  writer,  and 
inventor  of  instruments  still  familiar  to  us  and  bearing 
his  name. 

During  many  of  his  early  years  Hodge  lectured  on  Ob- 
stetrics in  the  Medical  Institute,  and  in  1835  was  elected 
Professor  of  Obstetrics  to  the  University  of  Pennsylvania, 
over  Meigs,  the  rival  candidate.  He  held  the  chair  for 
thirty-eight  years.  During  his  long  professional  life 
Hodge  published  a  number  of  valuable  works  on  both 
obstetrical  and  gynaecological  subjects,  notably,  "  Cases 
and  Observations  regarding  Puerperal  Fever"  (1833); 
"  Diseases  peculiar  to  Women,  including  Displacement  of 
the  Uterus"  (i860);  "Principles  and  Practice  of  Ob- 
stetrics" (1864);  and  essays  upon  "  Synclitism  of  the 
Fcetal  Head"  (1870).  His  writing  is  clear,  forcible, 
and  convincing,  though  it  must  be  admitted  that  much 
of  it  is  heavy.  As  a  teacher  he  was  greatly  respected. 
As  he  grew  old  he  became  almost  blind,  and  much  of  his 
writing  was  done  by  dictation,  his  work  on  "  Obstetrics" 
entirely  so. 


XIX.  CENTURY.     NOTABLE    NAMES.       465 

He  invented  that  form  of  forceps  which  is  still  in  com- 
mon use  in  this  country,  and  he  taught  its  value.  He  is 
equally  to  be  remembered  for  his  invention  of  uterine 
supports,  and  "  Hodge's  Pessary"  seems  to  be  as  well 
known  to  grateful  women  as  to  physicians.  He  was  quite 
a  mechanical  genius,  and  devised  various  tools  of  the 
trade  still  to  be  found  among  us. 

He  died  in  1873,  ^^  the  age  of  seventy-seven. 

Samuel  Henry  Dickson  was  another  Southerner  who 
made  a  part  of  his  reputation  in  the  North.  He  was  born 
in  Charleston  in  1798,  was  graduated  from  Yale  in  18 14, 
and  in  Medicine,  from  the  Pennsylvania  School,  in  18 19. 
Then  he  went  back  to  Charleston,  where  he  was  a  profes- 
sor in  the  Medical  School  from  1824  to  1834,  with  an 
interval  of  two  years,  after  1831.  For  three  years  from 
1847  he  taught  in  the  New  York  University;  then  again 
in  Charleston  from  1850  to  1857,  and  finally  for  the  year 
1859  at  the  Jefferson  School. 

Now  the  one  thing  most  conspicuous  about  Dickson, 
among  doctors,  was  the  charm  of  his  writings.  His  larger 
works  are  not  especially  noteworthy,  but  his  numerous 
journal  articles  and  volumes  of  essays  are  among  the  most 
attractive  contributions  to  our  medical  literature.  He  died 
in  1872. 

Samuel  George  Morton  was  a  distinguished  anatomist 
and  professor  in  the  Pennsylvania  School  from  1839  to 
1843.  He  was  born  in  Philadelphia  in  1799,  and  was  edu- 
cated there  and  in  Edinburgh.  His  great  work,  "  Crania 
Egyptiaca,"  gave  him  a  reputation  throughout  the  scien- 
tific world.    He  died  in  1851. 

While  such  were  the  doctors  in  civil  life,  a  few  army 
surgeons  lived  who  should  be  known  to  us  by  name  at 
least.  Thirty  years  ago  Harvey  E.  Brown,  an  army  sur- 
geon, wrote  out  for  the  Surgeon-General  a  detailed  ac- 
count of  the  Medical  Department  from  1775  to  1873.  It 
is  a  story  well  worth  reading.    The  disciplined  officer  tells 

30 


466  MEDICINE    IN   AMERICA. 

feelingly,  but  with  restraint,  of  the  struggle,  lasting 
through  a  century,  to  bring  up  that  important  branch  of 
our  public  service  to  the  level  where  it  should  be, — a  strug- 
gle against  the  ignorance,  stupidity,  and  obstinacy  of  suc- 
cessive Congresses,  and  the  frequent  cold  indifference  of 
the  War  Department  itself.  Suffice  it  here  to  name  the 
early  Surgeons-General  and  one  or  two  others  of  note. 

Of  Morgan,  Shippen,  Cochran,  Tilton,  Warren,  and 
Craik  during  the  Revolution  some  mention  has  already 
been  made.  Two  or  three  of  them  appear  on  the  register 
of  medical  officers  of  the  army  in  later  years. 

In  1798,  when  there  was  a  threat  of  war  with  France, 
the  same  James  Craik,  of  Virginia,  was  appointed,  by 
Washington's  request,  Physician-General.  The  man  had 
led  an  interesting  life.  A  Scotchman  by  birth,  he  had 
come  out  to  Virginia,  about  1750,  to  practise  medicine. 
He  had  accompanied  Washington  in  his  desperate  expe- 
dition against  the  French  in  1754,  and  the  year  following 
had  gone  with  Braddock's  unfortunate  little  army  against 
Fort  Duquesne.  After  that  he  practised  in  Virginia  until 
the  outbreak  of  the  Revolution,  when  he  went  with  Wash- 
ington to  the  field.  He  served  through  the  war  and  rose 
to  be  Physician  to  the  army,  serving  under  Cochran. 
With  the  collapse  of  the  French  war  scare  in  1800,  he  was 
mustered  out  of  the  service  and  returned  to  his  home 
near  Mt.  Vernon.  He  had  been  Washington's  physician 
for  many  years,  and  was  with  him  when  he  died,  a  wise 
old  man,  but  unable  to  subdue  a  disease  which  we  no 
longer  think  of  as  essentially  fatal. 

James  Tilton  (1745- 1822),  of  Delaware,  was  appointed 
Physician  and  Surgeon  of  the  army  in  March,  18 13,  and 
served  until  his  retirement  in  181 5.  He  had  been  a  dis- 
tinguished medical  officer  during  the  Revolution,  ranking 
fourth  in  the  list  of  hospital  surgeons  at  the  close  of  the 
war.  After  that  he  took  up  private  practice  again,  but 
continued  an  active  interest  in  public  affairs  and  rep- 


XIX.  CENTURY.     NOTABLE    NAMES.       467 

resented  his  State  in  Congress.  His  work  entitled 
"  Economical  Observations  on  Military  Hospitals  and 
the  Prevention  and  Cure  of  Diseases  incident  to  the 
Army"  is  interesting,  and  was  an  authority  a  hundred 
years  ago.^ 

He  served  with  great  distinction  and  satisfaction  to 
the  country  through  the  War  of  1812,  and  accomplished 
many  important  reforms.  While  still  in  active  service,  in 
1 814,  he  had  his  thigh  amputated  for  malignant  disease, 
but  recovered,  was  retired,  and  died  at  the  age  of  seventy- 
seven,  in  May,  1822. 

Joseph  Lovell,  the  first  Surgeon-General  properly  so 
called,  was  appointed  on  April  18,  181 8.  Lovell  was  a 
Massachusetts  man,  born  in  Boston,  December  22,  1788. 
His  grandfather  was  a  leading  member  of  the  "  Sons  of 
Liberty,"  and  had  been  taken  as  a  hostage  to  Halifax  by 
the  British  when  they  evacuated  Boston  in  1776.  Lovell's 
father,  James  S.  Lovell,  married  Deborah  Gorham,  "  a 
noted  Boston  belle ;"  Joseph  Lovell,  the  Surgeon-General, 
was  their  eldest  son.  He  was  educated  in  Boston  and 
was  graduated  from  Harvard  in  1807.  He  then  studied 
medicine,  and  had  just  begun  practice,  when  he  was  ap- 
pointed surgeon  of  the  Ninth  Infantry  on  the  outbreak 
of  the  War  of  18 12.  In  charge  of  the  general  hospital 
at  Burlington  and  serving  with  Generals  Scott  and  Brown, 
he  showed  exceptional  ability.  His  commission  in  1818 
was  very  popular  with  the  whole  army.  For  the  rest  of 
his  life  he  served  as  Surgeon-General,  and  with  great 
effectiveness.  He  reorganized  the  medical  regulations 
and  brought  the  department  up  to  a  condition  of  great 
efficiency.    He  died  on  October  17,  1836. 

Brown  says  of  him,  "  The  greatness  of  his  loss  to  the 
army,  and  especially  to  the  corps  which  he  may  almost  be 
said  to  have  brought  into  being,  can  hardly  be  exagger- 


See  Review  in  Medical  Repository,  1813. 


468  MEDICINE    IN    AMERICA. 

ated.  He  was  one  of  those  rare  and  lovely  characters  of 
whom  it  is  no  affectation  to  say  that  '  the  world  was  not 
worthy.'  Throughout  his  official  career  he  had  gained 
the  universal  respect,  admiration,  and  affection  of  all  with 
whom  he  was  associated.  His  predominant  characteristics 
were  a  strong  sense  of  the  dignity  of  his  position  and  of 
the  profession  to  which  he  belonged,  and  a  gentleness  of 
demeanor  in  all  his  relations,  both  official  and  personal, 
with  the  subordinate  officers  of  the  Medical  Staff.  .  .  . 
In  all  his  relations,  whether  as  Christian  philanthropist, 
profound  scholar,  skilful  surgeon,  experienced  officer,  or 
true-hearted  gentleman,  he  was  one  of  whom  the  Medical 
Staff  may  always  be  proud,  and  the  memory  of  whose 
good  life  is  written  on  every  page  of  its  history. 

''  In  1842,  the  officers  of  the  Medical  Corps  testified 
their  affection  for  his  virtues  by  the  erection  of  a  hand- 
some monument  over  his  grave  in  the  Congressional 
Cemetery  at  Washington." 

Thomas  Lawson  was  appointed  to  succeed  Lovell  on 
November  30,  1836.  The  contrast  between  the  two  was 
striking.  Lawson  was  a  man  of  great  force  of  character, 
a  stern  disciplinarian,  with  an  ardent  love  for  the  military 
profession,  and  a  high  sense  of  the  value  of  his  corps 
to  the  army.  He  was  determined  to  secure  for  it  every 
right  which  his  judgment  thought  best,  and  to  weed  out 
from  it  every  member  whom  he  thought  to  reflect  no 
credit  upon  it.  In  consequence,  he  was  frequently  in  col- 
lision with  both  his  superiors  and  inferiors,  but  he  was 
dismayed  neither  by  authority  nor  influence.  So  he  came 
to  be  sincerely  respected  and  admired,  but  he  won  no 
affection. 

Lawson  was  a  Virginian  by  birth.  He  first  saw  service 
as  surgeon's  mate  in  the  navy  in  1809,  but  was  trans- 
ferred to  the  army  in  181 1,  and  became  surgeon's  mate 
to  the  Sixth  Infantry.  In  181 3  he  was  promoted  to  sur- 
geon and  served  with  distinction  during  the  War  of  1812. 


XIX.  CENTURY.     NOTABLE    NAMES.       469 

In  1 82 1  he  was  transferred  to  the  General  Staff  as  the 
senior  surgeon  of  the  army.  As  medical  director  at  New 
Orleans,  in  the  Department  of  the  South,  and  during  a 
long  service  on  the  frontier  in  the  field,  he  acquired  a  great 
practical  experience  and  an  enviable  reputation.  His  chief 
conspicuous  service  as  Surgeon-General  was  during  the 
war  with  Mexico,  whither  he  accompanied  General  Scott, 
and  acted  as  chief  medical  officer  of  the  army  of  invasion. 

Though  a  Virginian,  he  remained  in  the  Union  service 
on  the  outbreak  of  the  Civil  War;  but  shortly  after  the 
attack  on  Sumter  he  was  obliged  to  resign  because  of  fail- 
ing health.  He  went  down  to  Norfolk,  and  died  suddenly 
on  May  15,  1861. 

Those  men  already  so  briefly  mentioned  in  this  chapter 
are  to  be  classed  as  belonging  truly  to  the  history  of  a 
time  now  far  behind  the  present  generation.  Born  in  the 
eighteenth  century,  their  work  was  done  mostly  in  the 
early  years  of  the  nineteenth,  and  with  the  naming  of 
them  the  purposes  of  this  book  have  been  accomplished. 

There  followed  immediately  a  generation  which  has 
hardly  yet  disappeared  from  our  midst;  men  known  in- 
timately to  many  of  us  now  living,  and  with  a  perspective 
upon  them  insufficient  for  true  historical  vision.  The 
active  lives  of  most  of  them  were  passed  prior  to  the 
great  Civil  War,  but  much  of  their  work  was  done  also 
in  more  recent  years,  and  for  that  reason  the  mere  naming 
of  the  names  of  a  few  of  them  must  suffice,  else  the  theme 
would  lead  us  on  to  forbidden  ground,  besides  expanding 
this  book  far  beyond  the  limits  set  for  these  modest 
covers. 

There  were  the  brilliant  brothers,  John  L.  Atlee  ( 1 799- 
1885)  and  Washington  L.  Atlee  (1808- 1878),  pioneers, 
with  Alexander  Dunlap,  E.  R.  Peaslee,  and  Gilman  Kim- 
ball, of  abdominal  surgery  in  America.  Their  struggles 
against  the  bitter  opposition  of  professional  conservatism, 
their  daring  work  and  their  successes,  all  too  tardily  rec- 


470  MEDICINE    IN   AMERICA. 

ognized,  will  make  a  chapter  of  recent  history  of  engross- 
ing interest  for  future  readers. 

Horace  Green  (1802- 1866),  Professor  of  Theory  and 
Practice  in  the  New  York  Medical  College,  was  the  first 
man  to  devote  himself  as  a  specialist  to  diseases  of  the 
nose  and  throat. 

Elisha  Bartlett  (1804-1855),  dehghtful  character,  ac- 
complished scholar,  teacher  in  many  schools,  —  Wood- 
stock, Pittsfield,  Dartmouth,  Baltimore,  Lexington, 
Louisville,  and  the  University  of  the  City  of  New  York, — 
should  be  known  to  every  student  of  our  literature. 

Samuel  D.  Gross  ( 1805-1884),  of  Philadelphia.  There 
is  a  name  which  one  passes  by  with  regret,  —  bibliog- 
rapher, surgeon,  teacher,  untiring  writer,  a  man  of  uni- 
versal sympathies  and  acquaintance,  and  a  friend  of  three 
generations.  No  physician  of  the  last  century  is  better 
known  to  all  of  us  to-day. 

Isaac  Ray  ( 1807-1881 ),  the  great  alienist,  the  first  man 
after  Rush  to  bring  permanency  to  our  literature  of  men- 
tal disease. 

Gurdon  Buck  (1807- 1877),  the  New  York  surgeon, 
whose  "  Extension"  is  a  household  world  in  all  hospitals. 

Alonzo  Clark  (1807- 1887),  a  name  with  which  to  con- 
jure,— great  teacher,  sound  practitioner,  wise  consultant, 
and  promoter  of  good  work. 

Henry  Ingersoll  Bowditch  (1808- 1892),  of  Boston. 
The  exponent  among  us  of  the  best  teaching  of  the  French 
School ;  known  among  other  things  for  his  work  on  dis- 
eases of  the  chest  and  his  exposition  of  paracentesis. 

Oliver  Wendell  Holmes  (1809- 1894),  best  beloved  of 
American  writers,  but  known  to  his  medical  brethren  as 
a  brilliant  anatomist,  and  the  first  to  maintain  the  thesis 
of  the  contagiousness  of  childbed  fever. 

Jonathan  Mason  Warren  (1811-1867),  of  Boston;  ac- 
complished son  of  a  famous  father;  cut  off  in  the  midst 
of  his  life-work ;  he  was  an  exponent  of  the  best  in  Amer- 
ican Surgery. 


XIX.  CENTURY.     NOTABLE   NAMES.       471 

Austin  Flint  (181 2-1 886),  of  New  York,  through  a 
long  professional  life  was  constantly  before  the  public  eye ; 
a  teacher,  a  practitioner,  and  the  author,  twenty  years  ago, 
of  the  best  books  on  general  medicine  in  the  English 
language. 

James  Marion  Sims  (181 3- 1883),  a  Southerner,  trans- 
planted to.  New  York;  the  brilliant  light  of  American 
gynaecology;  founder  of  a  great  hospital;  ingenious, 
resourceful  surgeon. 

Henry  Jacob  Bigelow  (1818-1890),  of  Boston,  the 
autocrat  of  New  England  Surgery.  Meteoric  craftsman, 
fascinating  teacher,  an  enthusiast  in  all  things,  a  master 
of  many ;  not  soon  to  pass  from  memory. 


CHAPTER    XVI  I. 

SOME   TENDENCIES   IN    MODERN    MEDICINE. 

Before  concluding  this  retrospect  of  medicine  and  its 
professors  as  they  have  been  in  the  America  of  our  an- 
cestors, it  may  be  interesting  to  readers — especially  to 
readers  belonging  to  that  large  class  felicitously  called 
laymen — to  glance  at  one  or  two  of  the  tendencies  of  the 
modern  doctor's  life, — its  pleasures,  hardships,  ambitions, 
and  conditions. 

The  first  thing  that  strikes  the  student  of  medical  his- 
tory is  not  so  much  the  great  advance  in  knowledge  among 
our  leading  men,  compared  with  the  best  knowledge  of 
the  past,  but  the  gradual  levelling  up  of  the  masses  of  the 
profession  and  the  sanity  of  their  outlook  on  the  problems 
of  the  doctor's  life.  This  levelling  up  was  not  the  imme- 
diate result  of  the  great  discoveries  and  teaching  of  the 
past.  We  have  seen  how  most  of  the  American  contem- 
poraries of  Sydenham,  and  the  Hunters,  of  Bichat  and 
Haller,  remained  in  a  state  of  blindness.  The  general  im- 
provement has  grown  out  of  the  fact  that  we  have  gradu- 
ally come  to  apply  to  our  medical  teaching,  as  to  our 
teaching  in  all  other  lines  of  endeavor,  the  American  prin- 
ciples of  higher  education;  the  meeting  the  demands  of 
our  masses  by  giving  them  of  our  best.  In  view  of  the 
backwardness  of  American  medical  education  up  to  a  few 
years  ago,  such  a  statement  may  sound  paradoxical.  We 
had  been  forever  comparing  our  darkness  with  the  en- 
lightenment of  the  great  European  centres,  and  telling 
of  our  own  ignorance.  But  such  telling  and  such  com- 
paring bore  their  fruit.  We  kept  looking  at  the  best 
things  among  those  foreign  folk,  and  crying  out  that  we 
472 


TENDENCIES. 


473 


should  lead  up  to  them  not  our  chosen  few,  but  our  rank 
and  file.  We  have  never  been  contented  with  looking  at 
the  state  of  that  European  rank  and  file,  nor  have  we  been 
willing  to  leave  our  people  at  such  a  level  as  we  have  seen 
over  there. 

That  dream  of  a  medical  education  which  seemed 
among  us  so  unattainable,  even  two  decades  ago,  is  every 
year  coming  nearer  to  realization.  Beginning  with  the 
high  requirements  set  by  the  great  schools  of  Baltimore, 
Philadelphia,  New  York,  Boston,  and  Chicago  within  the 
memory  of  men  still  young,  the  good  work  has  spread, 
until  now  there  is  hardly  a  State  in  the  Union  which  does 
not  boast  at  least  one  school  at  which  the  zealous  and 
diligent  student  may  find  a  scientific  education  of  a  high 
order. 

Gradually  the  requirements  for  admission  to  our  Med- 
ical Schools  have  been  raised ;  the  average  age  of  the  stu- 
dents is  higher;  more  and  more  the  matriculants  are 
found  to  be  holders  of  preliminary  degrees  in  arts  or 
sciences ;  indeed,  in  two  or  three  of  our  best  schools  that 
degree  is  a  prerequisite  for  admission.  The  high  stand- 
ard which  is  being  set  is  already  showing  results,  and  the 
sane  minds  in  the  community  are  coming  to  recognize  the 
meaning  and  the  value  of  the  man  highly  trained  for  his 
special  task. 

There  is  existing  at  the  same  time  one  of  those  tidal 
waves  of  gregarious  hysteria  such  as  sweep  over  society 
in  fairly  regular  cycles.  Just  at  present  this  is  taking  the 
form  of  a  faith  in  "Christian  Science;"  the  success  of 
which  has  stimulated  the  growth  of  sundry  similar  delu- 
sions, known  as  Dowieism,  Holy  Ghost  Societies,  and 
other  such.  These  lapses  from  reason  are  seen  not  only 
among  persons  of  some  degree  of  education,  but  even 
among  the  most  rude  and  ignorant  of  the  European 
peasantry, — like  the  Russian  Doukhobors  who  were  re- 
cently transported  to  northwestern  Canada,  and  took  to 


474  MEDICINE   IN   AMERICA. 

wandering,  by  the  thousand,  in  zero  weather,  barefooted, 
"  looking  for  Jesus." 

The  outbreak  of  Hahnemannism,  or  Homoeopathy,  in 
our  grandfathers'  days,  was  an  affair  of  quite  another 
type.  That  cult  rose  in  the  midst  of  other  cults  and 
"  schools."  It  did  not  appeal  to  the  scientific  men  of  the 
time,  but  it  did  appeal  to  the  laity  and  the  poorly  educated 
in  the  profession  weary  of  dosing  and  bickerings  and 
small  things  accomplished.  The  rise  of  homoeopathy 
would  be  impossible  to-day  with  our  more  general  intelli- 
gence and  accuracy  of  method.  The  vestiges  of  the  once 
famous  "  School"  still  linger  among  us,  —  a  nebulous 
simulacrum, — though  the  name  is  used  by  thousands  of 
well-educated  physicians  who  cling  to  the  rag  of  a  dis- 
credited therapeutics.  But  time  rectifies  all  things,  and 
we  must  beHeve  that  these  misguided  ones  will  some  day 
drop  this  semblance  of  a  thing  and  see  that  science  knows 
no  qualifications. 

We  must  recognize  the  fact,  too,  that  so  great  a  country 
as  ours  calls  for  doctors  of  various  training;  that  the 
highly  polished,  city-bred  product,  the  man  who  has  spent 
ten  or  more  years  of  his  life  in  an  academic  atmosphere, 
in  college,  medical  school,  laboratory,  hospital,  and  foreign 
travel,  is  not  likely  to  seek  his  life-work  in  remote  country 
districts.  On  the  other  hand,  such  districts  must  have 
their  doctors, — patient,  sturdy,  self-reliant,  industrious 
men,  who  will  live  in  the  open,  in  long  daily  rounds,  visit- 
ing hamlets  and  outlying  farms,  content  with  the  people 
and  the  social  conditions  to  be  found  in  the  woods  of 
Maine,  the  swamps  of  Mississippi,  or  the  mountains  of 
Idaho.  For  such  men  the  small  school  and  the  shorter 
course  of  study  still  exist.  It  is  well  that  they  should 
do  so. 

There  is  no  question  that  one  result,  at  present,  of  our 
higher  education  is  that  those  country  districts  are  not 
being  properly  furnished  with  medical  care;   while  in  the 


TENDENCIES.  475 

cities  the  supply  of  trained  men  greatly  exceeds  the  de- 
mand. The  report  for  1898-99  of  the  Commissioner  of 
Education  is  before  me.  From  it  one  learns  that  in  that 
year  there  were  23,778  medical  students  in  the  United 
States,  an  increase  of  345  over  the  previous  year.  Of 
these  men  21,401  were  matriculants  in  the  regular  schools 
of  medicine,  1802  in  the  homoeopathic  schools,  and  575  in 
various  irregular  institutions.  There  are  151  schools,  and 
all  but  fifteen  report  that  they  give  a  graded  course  of  four 
years,  and  in  several  the  months  of  required  attendance 
in  one  year  are  equal  to  the  total  required  attendance  of 
twenty  years  ago.  During  the  ten  years  from  1889  to 
1 899  the  number  of  students  of  regular  medicine  increased 
75  per  cent. ;  of  homoeopathy,  55  per  cent. ;  of  dentistry, 
301  per  cent. ;  of  pharmacy,  26  per  cent. 

There  were  4389  instructors  that  year  of  1898-99,  and 
49 1 1  students  were  graduated;  and  of  those  students 
some  480  held  the  degree  of  A.B.  or  B.S. 

What  becomes  of  these  men  when  they  have  been  grad- 
uated? Where  do  they  seek  their  work?  Into  what 
special  types  of  doctors  do  they  develop  ?  Do  they  go  out, 
as  did  their  fathers,  to  minister  to  the  masses  scattered 
over  the  country,  finding  work  of  all  kinds  ready  to  their 
hand,  but  at  great  labor  and  scanty  remuneration ;  in  the 
careers  of  general  practitioners?  or  do  they  congregate 
in  the  cities  to  wait;  to  take  up  narrow  lines  of  work,  to 
hope  that  practice  will  come  to  them;  in  the  careers  of 
city  specialists?  or  are  there  such  things  as  country  spe- 
cialists and  city  general  practitioners  ? 

These  are  interesting  and  far-reaching  questions,  and 
not  altogether  possible  to  be  answered  from  the  scanty 
data  at  hand.  One  may  draw  some  striking  and  instruc- 
tive conclusions,  however,  from  a  study  of  the  recent 
graduates  of  one  school.  It  is  a  study  in  statistics,  to 
be  sure,  but  even  statistics  may  at  times  be  made 
luminous. 


476  MEDICINE    IN   AMERICA. 

In  the  ten  years  from  1892  to  1901  there  were  gradu- 
ated from  the  Harvard  School  some  820  men,  of  whom 
there  is  record,  and  of  these  men  the  following  inquiries 
recently  were  made : 

( 1 )  Your  name  and  medical  class  ? 

(2)  Name  and  population  of  your  community? 

(  3  )   Are  you  a  general  practitioner  or  specialist  ? 

(4)  What  is  your  specialty? 

(5)  Do  you  combine  a  general  practice  with  your 
specialty  ? 

(6)  If  a  general  practitioner,  do  you  anticipate  be- 
coming a  specialist  ? 

(7)  If  a  specialist,  have  you  ever  been  a  general  prac- 
titioner ? 

Now,  the  Harvard  School,  as  we  know,  is  one  of  our 
oldest  foundations.  It  is  located  in  an  ancient  and  con- 
servative community,  and  draws  its  students  from  a  peo- 
ple given  to  commercial  and  manufacturing  pursuits,  little 
to  agricultural.  Its  graduates  settle  mostly  in  the  New 
England  States,  though  it  is  represented  in  scattering 
fashion  almost  everywhere  throughout  the  country,  the 
colonies,  and  among  the  Spanish- American  peoples. 

It  was  one  of  the  schools  early  to  set  a  high  standard 
for  matriculants  and  graduates,  to  require  a  four  years' 
course  of  study  for  the  degree,  and  of  late  years  to  de- 
mand of  its  students  on  admission  that  they  hold  a  pre- 
liminary degree  in  arts  or  sciences. 

To  the  inquiries  made,  487  men,  or  nearly  two-thirds, 
replied.  The  summary  of  their  answers  is  given  in  the 
table  on  the  following  page. 

A  study  of  these  figures  gives  one  various  information, 
some  of  which  is  surprising.  In  spite  of  the  general  as- 
sumption of  the  contrary,  it  is  found  that  a  minority  of 
the  men  are  settled  in  large  cities,  that  is,  in  cities  of 
100,000  or  more.  The  men  in  large  cities  number  191 
out  of  487. 


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MEDICINE    IN    AMERICA. 


In  the  small  cities  (10,000  to  100,000)  are  to  be  found 
229  men,  or  nearly  half  the  total.  Twenty-nine  men  are 
in  the  army  and  navy  or  are  unclassified,  and  only  thirty- 
eight  are  in  places  of  less  than  10,000  inhabitants,  that  is, 
in  country  practice. 

Perhaps  the  most  interesting  fact  is  that  of  the  487  men, 
only  96  are  pure  specialists.  Of  the  remaining  391,  13  are 
unclassified  and  378  are  general  practitioners.  The  gen- 
eral practitioners  say  this  of  themselves  in  qualification : 
Ninety-nine  combine  some  specialty  with  their  practice,  yj 
expect  some  day  to  abandon  general  practice  for  a  spe- 
cialty, and  202  are  and  expect  to  be  Simon-pure  general 
practitioners.  Two  men  only,  and  they  are  of  the  class  of 
1892,  state  that  they  are  specialists  w^ho  have  been  general 
practitioners. 

The  specialists  are  divided  into  the  following  groups : 


Surgery,  42. 

Gynaecology,  19. 

Medicine,  12. 

Otology,  9. 

Laryngology,  9. 

Aurist  and  Oculist,  7. 

Pathology,  7. 

Dermatology,  7. 

Oculists,  6. 

Eye,  Ear,  Nose,  and  Throat,  5. 

Chemistry,  5. 

Orthopaedics,  5. 

Children's  Diseases,  4. 

Neurology,  4. 

Genito-Urinary,  4. 

Infectious  Diseases,  3. 

Bacteriology,  3. 

Insanity,  3. 


Anatomy,  2. 

Physical  Training,  2. 

Obstetrics,  2. 

Gastro-Intestinal,   i. 

Nutrition,  i.. 

Aurist,  I. 

Lungs,  I. 

Dentistry,  i. 

Obstetrics  and  Children's  Dis- 
eases, I. 

Stomach  Diseases,  i. 

Anaesthetist,  i. 

Military  Medicine,  i. 

Paediatrics,  i. 

Bacteriology  and  Orthopae- 
dics, I. 

Internal  Medicine  and  Nervous 
Diseases,  i. 


The  facts  which  these  figures  illustrate  compare  in  an 
interesting  fashion  with  various  assumptions  which  have 
been  made  of  late  years  by  many  men  writing  on  ten- 
dencies in  medicine,  and  chiefly  as  regards  the  asserted 
inevitable  specializing  of  all  members  of  the  profession. 


TENDENCIES.  479 

The  time  has  long  passed  for  discussing  the  propriety 
and  advantages  of  speciaHzing.  Not  forty  years  ago  there 
was  a  serious  attempt  made  in  the  American  Medical 
Association  to  legislate  against  specialists  and  to  declare 
such  men  to  be  disciples  of  the  evil  one.  Through  the 
efforts  mainly  of  Henry  L  Bowditch  such  attempted  legis- 
lation was  brought  to  naught.  Nevertheless,  the  preju- 
dice against  specialists  continued  wide-spread  for  many 
years.  In  the  course  of  time,  however,  all  reflective  men 
have  come  to  see  that  specializing  in  medicine  is  as  essen- 
tial to  true  progress  as  is  specializing  in  all  skilled  labor 
throughout  the  world.  Very  properly,  the  discussion  has 
advanced  beyond  that  point. 

At  present,  such  discussion  as  there  is  turns  on  the 
question  whether  all  physicians  are  not  specialists  and 
must  not  turn  to  specialties;  and  whether,  in  the  evolu- 
tion of  events,  the  "  Family  Doctor"  and  the  general 
practitioner  are  not  to  become  obsolete.  A  recent  writer 
goes  so  far  as  to  say,  "  That  the  family  adviser,  the  phy- 
sician who  stands  in  the  most  intimate  possible  relation 
to  the  family,  should  cease  to  exist,  is  a  fact  we  may  well 
regret,  but  which,  nevertheless,  we  are  bound  to  face."  ^ 
And,  again,  "It  is  to  be  hoped,  therefore,  that  the  term 
'  general  practitioner'  as  opposed  to  '  specialist'  will  soon 
go  the  way  of  other  inaccurate  terms."  Of  course,  if 
the  question  is  merely  one  of  definition,  the  old-time  gen- 
eral practitioner  has  largely  disappeared  already;  but 
most  of  us — laymen  and  physicians  alike — understand  by 
the  term,  as  used  to-day,  a  man  who  is  competent  to  prac- 
tise internal  medicine  and  general  surgery,  but  does  not 
attempt  the  more  difficult  operations,  nor  encroach  far 
upon  the  field  of  the  narrow  specialists, — the  oculist,  the- 
aurist,  and  such. 

That  such  general  practitioners  are  in  a  fair  way  to 


^  Boston  Medical  and  Surgical  Journal,  vol.  cxlvii.  p.  219,  1902. 


48o  MEDICINE    IN    AMERICA. 

disappear  there  is  abundant  reason  to  doubt.  Such  are  the 
men  who  become  "family  advisers;"  and  it  is  unhkely 
that  the  community  will  agree  to  part  with  them.  The 
question  is  one  of  supply  and  demand;  and  if  cjualified 
graduates  in  medicine  cease  to  do  such  work,  the  com- 
munity will  turn  to  the  unqualified. 

Here  are  twenty  consecutive  cases  taken  at  random 
from  the  case  book  of  a  "  family  adviser"  in  large  city 
practice:  A  tea  drunkard,  a  child  with  diarrhcea,  a  child 
with  slight  follicular  tonsillitis,  a  young  man  with  a 
"  tobacco  heart,"  a  man  with  a  slight  troublesome  arthri- 
tis (rheumatism),  a  girl  with  a  felon,  two  cases  of  vacci- 
nation, a  woman  with  headache  from  constipation,  a  case 
of  boil  on  the  neck,  a  case  of  bronchitis,  a  neurasthenic 
woman,  a  child  with  cervical  adenitis  ("  scrofula"),  two 
cases  of  debility  from  overwork,  a  case  of  frost-bite,  a 
case  of  conjunctivitis  ("pink-eye"),  and  three  cases  of 
influenza.  The  curious  layman  asks,  To  whom  would 
most  of  these  persons  have  turned  had  there  been  no 
"  family  adviser"  ?  Then  there  is  that  very  large  class 
of  cases  which  seek  the  medical  adviser  as  their  ancestors 
sought  the  priest.  Their  needs  are  mental  and  emotional 
rather  than  physical,  and  for  them  the  family  doctor  is 
still  a  very  real  need. 

However  all  this  may  be, — and  the  present  writer  has 
no  purpose  of  maintaining  a  thesis, — the  figures  of  our 
table  show  that  in  the  last  ten  years,  in  a  conspicuous 
group  of  highly  trained  men,  there  appears  no  increasing 
tendency  to  abandon  "  general  practice." 

Aside  from  this  matter  of  specialism  in  practice,  there 
is  the  further  interesting  development  among  us  of  labo- 
ratory students ;  sometimes  loosely  called  "  scientific 
men"  to  distinguish  them  from  practitioners  of  medicine. 
Of  course,  they  are  no  more  "  scientific  men"  in  the  literal 
and  proper  sense  than  are  the  careful  clinicians  who  make 
observations  and  draw  logical  conclusions.    The  practice 


TENDENCIES.  481 

of  setting  them  apart  and  applying  to  them  a  term  which 
should  embrace  all  honest  doctors  is  unfortunate,  and 
tends  to  create  an  erroneous  impression.  Of  late  years, 
too,  there  has  come  into  use  the  term  "  scientific  medi- 
cine," as  though  there  existed  alongside  of  it  such  a  thing 
as  unscientific  medicine.  The  term  "  antiseptic  surgery" 
is  disappearing  from  our  vocabulary,  for  septic  surgery 
has  ceased  among  us,  let  us  hope.  "  Scientific  medicine" 
and  "  antiseptic  surgery"  should  be  consigned  to  a  com- 
mon limbo. 

You  may  see,  from  this  outline  of  some  of  the  various 
interests  which  occupy  modern  doctors,  how  far  they 
have  drifted  from  the  simple  lines  in  which  their  grand- 
fathers moved.  In  many  ways  the  pursuit  of  medicine 
has  become  something  quite  distinct  from  what  it  once 
was;  but  it  has  always  drawn  to  it  many  of  the  best 
minds  in  the  community,  as  it  continues  to  do,  and  one 
is  often  asked  what  are  the  pleasures  and  attractions  of 
the  physician's  life. 

That  is  a  title  for  the  mellow  pen  of  age,  "  The  Pleas- 
ures of  the  Doctor's  Life;"  yet  so  suggestive  a  query 
deserves  an  answer  of  some  sort,  though  each  of  us  may 
hold  his  own  opinions. 

There  are  a  dozen  minor  pleasures  common  to  all 
physicians,  and  pleasures  of  sundry  kinds  as  various  as 
the  special  tasks  to  which  a  man  may  turn  his  energies. 
To  the  laboratory  investigator,  the  chemist,  the  patholo- 
gist, the  physiologist,  the  anatomist,  there  is  the  fascina- 
tion of  study, — a  fascination  which  not  even  the  loss  of 
his  senses  can  take  from  him  altogether.  Many  writers 
have  told  in  charming  words  the  joy  of  the  naturalist's 
life.  It  is  much  the  same  with  these  other  men  of  science. 
In  a  congenial  atmosphere,  uninterrupted  by  the  sordid 
cares  which  burden  the  business  of  most  men,  and  with 
responsibilities  less  grave  than  weigh  upon  their  prac- 
tising colleagues,  they  lead  the  life  of  students,  but  of  stu- 

31 


482  MEDICINE    IN    AMERICA. 

dents  whose  progress  is  constant  and  their  horizon  the 
universe.  They  are  banded  together  for  mutual  improve- 
ment; they  have  a  sympathetic  and  kindred  audience 
ready  to  hear  what  they  have  to  impart.  The  good  things 
they  do  are  quoted  and  rehearsed  in  all  civilized  lands; 
they  are  continually  adding  to  the  sum  of  human  knowl- 
edge. What  they  contribute  bears  most  directly  on  one 
of  the  greatest  problems  of  existence, — the  health  and 
happiness  of  the  human  family;  and  they  are  constantly 
deferred  to  and  consulted  by  their  fellow-laborers  in  other 
fields  of  medicine.  Truly  it  is  a  vocation  full  of  profit 
and  pleasure  and  honor. 

At  the  other  extreme  of  the  medical  fraternity,  though 
in  many  ways  closely  in  touch  with  these  student  folk, 
are  those  general  practitioners  or  family  advisers  of  whom 
we  have  heard  tell ;  and  the  most  familiar  type  of  these  is 
the  country  doctor.  A  great  many  words,  glowing  and 
kindly,  appreciative  and  sympathetic,  simple  and  pathetic, 
have  been  written  about  these  same  country  doctors.  Per- 
haps the  best  word  of  all — a  tale  that  makes  one  throb 
with  pride  in  human  nature,  so  fine  is  it,  so  virile,  and  so 
wholesome — is  that  story  of  "  Ian  Maclaren's"  called  "  A 
Doctor  of  the  Old  School." 

It  is  all  true  enough.  There  are  such  men,  and  they 
are  not  disappearing  from  our  midst,  in  spite  of  heroics. 
We  all  know  what  the  life  entails, — endless,  ceaseless 
labor,  long  journeyings  by  day  and  by  night,  often  a 
round  of  two  days  before  home  is  reached  again,  little 
congenial  companionship  of  modern  science,  scanty  pay, 
and,  hardest  of  all  often,  the  sense  that  the  world  is 
moving  on,  leaving  this  workman  hopelessly  in  the  rear. 
But  there  must  be  some  compensation,  though  many  do 
not  admit  it.  There  is  the  old,  ever-present  sense  of  ac- 
complishment ;  the  having  plenty  of  work  to  do,  which 
we  know  is  the  greatest  pleasure  the  world  has  for  most 
of  us ;    the  stimulation  of  great  responsibility ;    the  pecu- 


TENDENCIES.  483 

liar  realization  that  in  one's  self  alone  reside  powers,  and 
capacity,  and  knowledge  denied  to  all  one's  neighbors. 
Then  there  is  that  life  in  the  open,  the  companionship  of 
nature,  of  horses  and  dogs,  of  trees,  flowers,  fields,  sky, 
and  clean  air;  albeit  cold  and  snow,  heat  and  rain  may 
come  to  qualify.  But  men  are  found  for  it  all,  and  tar- 
dily folk  recognize  their  value  and  their  services.  And 
these  country  doctors  surely  come  to  know  life.  In  that 
there  is  a  certain  great  satisfaction.  Probably  to  no 
others  in  the  world  are  the  strength  and  weakness  of  hu- 
manity more  completely  laid  bare, — its  ambitions,  strug- 
gles, failures ;  its  feebleness  and  its  success,  its  meanness 
and  its  greatness. 

That  is  a  field  for  study,  exhaustless,  fascinating,  pa- 
thetic, contemptible,  terrible.  It  ends  by  making  its  vota- 
ries sneering  sceptics  or  great-hearted  philosophers;  and 
with  all  these  men,  however  humbly  stationed,  whatever 
their  temperament  may  be,  there  is  that  ever-present  fact 
of  which  we  know, — they  have  their  place  in  one  great 
brotherhood. 

There  is  a  third  class  of  doctors  whose  lives  are  but  little 
less  strenuous,  though  less  arduous,  than  those  of  their 
country  brethren.  Of  them  we  often  hear  that  their  lines 
are  laid  in  easy,  pleasant  places.  They  are  the  highly 
trained,  successful  city  men,  who  come  to  be  known  to  the 
laity  as  the  great  consultants.  Specialists  they  are,  of 
course,  and  in  diverse  lines,  but  most  of  them  can  look 
back  upon  careers  that  are  not  dissimilar.  Given  special 
qualifications  and  advantages  at  the  outset  of  life,  perhaps, 
it  is  interesting  to  look  at  the  details  of  their  early  train- 
ing, and  so  to  make  clear  some  of  those  other  pleasures 
which  medicine  affords. 

Most  of  these  men,  in  whatever  country  they  be  found, 
but  more  especially  in  America,  are  persons  of  University 
training,  holding  degrees  in  arts  or  science;  and  from 
our  colleges  they  are  passed  on  directly  into  the  medical 


484  MEDICINE    IN    AMERICA. 

schools.  In  them  they  take  the  course  with  all  the  others, 
and  for  those  four  years  their  experiences  are  the  same  as 
fall  to  the  lot  of  the  future  laboratory  student  or  country 
doctor ;  but  with  this  exception,  that  about  the  middle  of 
their  terms,  usually  in  their  third  year  of  study,  they  begin 
to  look  forward  to  and  prepare  for  hospital  work.  Such 
preparation  consists  commonly  in  finding  positions  as  stu- 
dent assistants  or  dressers  in  the  out-patient  departments, 
where  they  work  for  a  few  months,  whether  with  sur- 
geons, physicians,  or  other  specialists. 

The  great  prize  held  out  to  students  ambitious  of  per- 
fecting themselves  is  an  assignment  as  house-officer  to  a 
hospital,  for  a  residence  of  something  like  two  years,  after 
graduation.  For  these  positions  the  competition  among 
students  is  very  keen,  as  the  places  mean  a  great  experi- 
ence acquired  in  a  short  time  and  under  superiors  of  pre- 
sumed ability. 

That  hospital  life  and  what  it  means  to  a  young  man  at 
the  outset  of  his  career  is  another  of  the  unique  pleasures 
about  which  folk  inquire.  There  is  no  parallel  in  the  other 
professions,  though  it  approaches  in  some  things  the  ex- 
periences which  a  young  army  or  naval  officer  knows. 
The  medical  graduate  has  just  completed  his  four  years  of 
incessant  grind,  in  which  he  has  been  a  passive  receptacle 
for  the  outpourings  of  many  teachers;  he  has  won  his 
spurs,  in  a  fashion,  by  winning  the  hospital  place ;  and  by 
a  process  of  quick,  graded  promotion  he  is  to  reach  a  posi- 
tion of  real  responsibility.  In  the  best  hospitals  the  dis- 
cipline from  top  to  bottom  is  not  unmilitary.  There  are 
men  of  many  ranks :  the  senior  physicians  and  surgeons, 
mature  men  mostly,  of  distinction  in  the  profession ;  next, 
tlieir  immediate  juniors  or  assistants,  sometimes  called 
"  physicians  to  out-patients,"  men  often  well  advanced  in 
their  careers.  These  two  groups,  with  the  various  spe- 
cialists, constitute  the  staff  proper,  and  are  wont  to  hold 
their  places  through  their  most  productive  years.     Then 


TENDENCIES.  485 

we  come  to  the  resident  house  staff,  the  young  men  of 
whom  this  tale  is  told.  They  are  divided  variously  in 
various  hospitals  and  are  known  by  various  names ;  but  it 
comes  to  this,  that  usually  there  are  four  of  them  assigned 
to  each  senior  surgeon  and  two  or  three  to  each  senior 
physician.  One  often  is  tempted  to  envy  the  youngest 
of  these  house-officers  as  he  starts  off  with  the  prospect  be- 
fore him  of  sixteen  to  twenty-four  months  of  congenial, 
absorbing  work.  It  is  a  life  the  charm  of  which  grows 
on  one;  men  often  come  to  look  upon  their  hospital  as 
upon  their  alma  mater,  and  to  turn  back  to  it  in  after  years 
with  equal  pride  and  regret. 

The  externe,  or  neophyte  at  the  life,  is  set  to  simple 
tasks;  to  record  keeping,  to  making  chemical  and  other 
such  investigations,  to  bandaging  and  dressing,  to  ether- 
izing, and  to  general  utility  work.  Then,  after  a  period 
of  probation,  he  is  advanced  a  place.  His  duties  are  still 
much  the  same,  but  with  increased  responsibilities;  per- 
haps he  goes  with  the  ambulance  to  accident  and  emer- 
gency calls,  or  assists  the  out-patient  surgeon  in  the  rou- 
tine of  minor  surgery,  taking  his  chance  at  operating  now 
and  again  upon  some  lesser  case.  His  next  step  is  dis- 
tinctly an  advance.  Whether  as  medical  or  surgical  assist- 
ant, he  is  now  given  the  charge  of  wards  and  some  of  the 
serious  responsibility  of  the  graver  cases.  He  makes  ex- 
aminations, sees  to  the  conduct  of  routine  treatment,  takes 
his  orders  directly  from  the  visiting  staff,  assumes  more 
or  less  of  the  burden  in  emergencies,  and  acts  as  second 
assistant  at  major  operations. 

Finally,  in  the  last  months  of  his  hospital  residence,  he 
comes  to  the  highest  attainable  grade, — he  becomes  house- 
physician  or  house-surgeon,  or  "  house,"  or  senior  house- 
officer,  or  head  interne,  according  to  the  local  term  in 
vogue.  At  any  rate,  he  becomes  a  very  important  and 
dignified  personage. 

The  college  "  senior"  is  as  nothing  to  him.     He  has 


486  MEDICINE    IN    AMERICA. 

men  under  him  who  smile  and  run  at  his  bidding,  and  call 
him  "  Sir;"  the  externe  trembles  before  him  and  stands 
in  his  presence;  he  talks  on  easy  and  familiar  terms  with 
officers  of  the  junior  staff  and  is  affable  with  the  visiting 
chief,  whose  right  hand  he  is.  His  responsibilities  are 
really  great  and  his  duties  onerous.  The  smooth  running 
of  the  whole  "  service"  rests  with  him.  He  must  know 
all  the  cases,  and  must  treat  personally  the  more  difficult, 
and  have  an  eye  to  those  of  his  junior.  He  must  consult 
with  the  hospital  authorities  about  endless  details;  he 
must  supervise  and  assign  much  of  the  work  of  his  sub- 
ordinates,— the  internes,  the  nurses,  and  other  attendants ; 
he  must  see  and  treat  all  accident  cases,  many  of  which 
are  of  the  gravest  kind,  and  he  must,  in  serious  emergen- 
cies, act  for  himself  or  send  for  counsel,  as  his  judgment 
may  dictate.  He  must  stand  ready  to  institute  and  ini- 
tiate new  modes  of  procedure  in  diagnosis  and  treatment, 
and  undertake  all  manner  of  investigations  for  which  cir- 
cumstances may  call.  He  must  be  prepared  night  and  day 
to  meet  and  assume  all  sorts  of  unexpected  duties  and 
risks,  such  as  the  life  in  a  great  hospital  constantly  pre- 
sents ;  he  must  take  the  leading  part  in  assisting  his  chief 
in  operations,  examinations,  the  conduct  of  clinics,  the 
marshalling  of  patients  and,  often,  the  preparation  of  ma- 
terial. In  short,  he  must  be  a  very  dens  ex  machina, — 
always  ready,  cheerful,  competent,  vigorous,  and  unruf- 
fled. Of  course,  it  is  a  position  of  great  difficulty  and  im- 
portance and  calls  out  the  best  that  is  in  a  man.  Mere 
brains  do  not  suffice.  Discretion,  endurance,  adaptability, 
and  that  rare  quality  we  call  tact  are  needed ;  and  proper 
courtesy  and  breeding  count  for  something  in  such  a  place. 
Few  young  men  in  any  vocation  have  better  opportunities 
than  the  senior  house-officer  of  a  great  hospital  to  show 
the  stuff  that  is  in  them ;  and  it  must  truly  be  said  that 
by  their  work  in  that  position  men  often  are  made  or 
marred  for  life. 


TENDENCIES.  487 

Such  are  some  of  the  tasks  and  duties  of  the  hospital 
life,  and  it  can  be  seen  that  the  compensations  are  not  few. 
Authority  alone  is  a  great  stimulus;  and  the  doing  of 
important  things  for  the  welfare  of  one's  fellow-beings, 
probably  for  the  first  time,  is  a  unique  pleasure.  These 
men  are  breathing  a  very  vital  atmosphere,  which  is 
always  throbbing  with  new  excitements  and  new  interests. 
They  are  learning  new  things  every  day,  and  they  are 
putting  into  practice  the  theories  they  have  been  taught. 
These  things  they  are  doing,  too,  in  congenial  comrade- 
ship and  friendly  rivalry.  They  are  living  in  a  little  world 
all  their  own;  they  are  very  human;  they  watch  each 
other's  work,  discussing  and  comparing,  and,  perhaps, 
greatest  satisfaction  of  all,  as  they  come  to  find  them- 
selves, they  are  learning  to  weigh  and  estimate  and  criti- 
cise their  chiefs. 

Surely  to  the  right-thinking  man  it  is  a  very  happy 
time  of  life, — much  to  be  regretted,  often  to  be  looked 
back  upon,  and  greatly  to  be  prized  while  still  in  hand. 

From  all  this  the  future  specialist  is  graduated  in  the 
course  of  time,  and  then  comes  the  question,  What  to  do 
and  how  to  do  it?  If  he  is  still  young  and  has  money 
and  leisure,  he  may  go  to  Europe,  to  learn  the  languages, 
to  push  his  studies,  to  see  other  men  and  other  methods, 
a  very  broadening  and  helpful  experience.  At  any  rate, 
his  day  for  all  such  things  soon  passes.  He  comes  home, 
settles  himself  down,  gives  forth  to  the  world,  through 
card  and  "  shingle,"  his  whereabouts  and  purposes,  and 
humbly  joins  the  ranks  of  those  who  wait. 

This  is  no  essay  on  how  to  succeed  in  life.  I  fancy 
most  men  take  a  plenitude  of  advice,  and  then  follow 
their  own  bent.  The  true  qualifications  are  inborn  and 
cannot  be  supplied.  That  is  as  true  in  medicine  as  in  all 
else ;  but  courage,  endurance,  and  a  willingness  to  under- 
take what  comes  properly  to  hand,  backed  by  such  a  train- 


488  MEDICINE    IN    AMERICA. 

ing  as  we  have  seen,  go  far  to  make  strong  men  successful 
in  this  busy,  modern  world. 

After  all,  I  take  it  that  the  great  underlying  pleasure 
and  satisfaction  of  the  doctor's  life  lies  in  something 
which  in  degree  is  common  to  all  toilers  in  this  world, — 
in  the  sense  of  something  accomplished,  of  work  done,  of 
work  in  itself.  Yet  there  is  more  than  that  in  it;  the 
workman  is  indeed  individualized,  but  he  belongs  to  a  vast 
army.  There  is  in  the  work  for  him  a  great,  uplifting 
sense  of  fellowship.  The  curtain  was  drawn  aside  when 
he  first  crossed  the  threshold  of  his  alma  mater,  which 
opened  to  him  one  door  of  the  many  standing  wide  to  the 
brotherhood  of  science.  It  is  no  local  party  or  section 
which  he  claims  as  his  own;  there  is  no  conspiracy,  or 
scheming,  or  secrecy,  or  clash  of  arms.  His  fraternity 
is  world-wide;  it  embraces  all  lands  and  all  peoples  who 
have  joined  with  him  in  the  finest,  the  noblest,  the  most 
absorbing  quest  ever  known  to  man, — the  search  after 
Truth. 

That  is  the  essence  of  what  is  brought  to  the  student 
of  medicine  with  almost  the  first  breath  he  draws  at  his 
novel  tasks.  The  sense  of  it  all  comes  to  him  slowly. 
Sometimes  its  full  meaning  is  never  wholly  revealed ; 
sometimes,  in  the  struggle  for  existence,  in  personal 
rivalry,  in  petty  misery,  in  money  getting  and  money 
losing,  he  forgets  or  lapses ;  but  he  cannot  avoid  the  great 
central  fact  if  he  would.  Over  the  true  votary  the  segis 
is  always  thrown,  and  the  deserter  must  wander  far  if  he 
would  escape  its  shadow. 

Surely,  my  friends,  who  have  followed  me  so  far, 
enough  has  been  said  to  demonstrate  the  meaning  of  the 
medical  life  here  in  America.  It  has  a  very  real  and  fruit- 
ful past,  a  very  vital  present,  and  a  future,  let  us  hope, 
which  some  day  may  mean  as  much  to  mankind  as  do 
those  other  institutions  in  the  land  of  which  we  boast. 


INDEX. 

PAGE 

Abbott,  Gilbert  412 

Abercrombie,    General    41 

Abernethy,  John    209,  235,  236,  266,  287,  345,  350,  455 

Achilles     11 

Adam  345 

Adams,  John  140,  154,  156,  174,  308 

Adams,  Samuel 154 

Alexander    , 63,  77 

Alexander,  Nathaniel  117 

Allen,  F.  P 454 

Amboy  131 

Amherst,  General  41,  283,  298 

Amory,  Charles 420 

Andral  206,  363,  364 

Andre    120 

Anne,    Queen    12, 41 

Appleton,  Nathaniel  Walker 195 

Appleton,  William  420 

Apuleius    399 

Arden,  Jane  283 

Arnold,  Benedict   120, 299 

Arnold,   Jonathan    116 

Arnold,  Richard  D 437 

Ashhurst  400 

Aspinwall   116 

Association,  American  Medical  427-445 

Atlee,  John  L 469 

Atlee,  Washington  L 469 

Babington,  William  287,  359 

Bache,  Franklin   459 

Bacon,  Francis   307 

Bagnall,   Anthony    21 

Bailey,   Richard    192, 284 

Bally,  J.  R 453 

Banks  287 

Bard,  John 93,  95,  98,  100,  102,  105,  106,  121 

Bard,  Samuel   63,  94,  184,  193,  197,  202,  238,  284,  290,  301,  390 

Barker,  Sir  William 282 

Bartlett,  Elisha  470 

Bartlett,  John   128,  194,  390 

Bartlett,  Josiah  n6 

489 


490  INDEX. 

PAGE 

Barton,  John  Rhea 182,  210,  310,  333,  334,  376 

Bartram     63 

Batchelder,  Joseph 107 

Bateman,  Michael 242 

Baudelocque  452 

Bayliss,  William 107 

Beattie   462 

Beaumont,  William  452,  453,  454 

Beck,  John  Broadhead  458 

Beck,  Lewis  C 459 

Beck,  Theodoric  Romeyn   432,  456,  457,  458 

Bedford,  Gunning  S 239,  437,  438 

Beekman,  Gerardus  33 

Belcher,  Tom 345 

Bell,  Charles   235,  345,  444 

Bellingham,   Samuel    27, 80 

Bell,    John    209,  222,  223,  224.  226,  227,  228,  236,  237,  238, 

336,  345,  346 

Benezet,  Anthony 178 

Benton  370 

Berry,  Thomas   I95 

Bethlehem     131 

Bichat    206,  276,  461,  472 

Bigelow,  H.  J 262,  308,  315,  324,  344,  412,  415,  416,  446,  47i 

Bigelow,  Jacob   137,  158,  i99,  234,  255,  256,  262,  307-328,  367, 

369,  370,  413,  42s,  426,  449 

Billings,  J.  S 204,  232,  337,  446 

Black  (Edinburgh)   221,  302 

Blythe,  Rev.  James,  D.D 272 

Boerhaave    13,  I5,  68,  145,  174,  290,  294 

Bohun,  Lawrence  21 

Bond,  Phineas  81, 84 

Bond,  Thomas    79,  80,  81,  82,  84,  92,  149,  179,  390 

Boott,  Francis  4^5 

Bowditch,  Henry  1 445,  470,  479 

Bowditch,  J.  1 420 

Bowdoin,  James   256 

Boylston,    Thomas    45 

Boylston,    Zabdiel    41,  44,  45,  47,  50,  51,  52,  53,  54,  64,  65, 

74,  179,  194,  202 

Braddock,    General    41, 82 

Bradlee,  F.  H 420 

Brashear    243 

Brewer,  Chauncey   ^^7 

Brodie,   Benjamin    248,  350,  455 

Brooks,   John    ^  ^5 

Brougham,  Lord 33^ 

Brown.  Charles  Brockden   183,  276,  290 


INDEX. 


491 


PAGE 

Brown,  F.  H 8,  25,  27 

Brown,    General 467 

Brown,  Harvey  E 465 

Brown,  James  223 

Brown,  John   161,  162 

Brown,  Samuel 223,  273,  384 

Bryant,  John   420 

Bryant,  W.  C 297,  328 

Buchan,  Lord 332 

Buchanan,  A.  H 444 

Buck,  Gurdon   417,  470 

Buckminster 254 

Buell,  William 188 

Bull,  William    41,  68,  80 

BuUard    254 

Burgoyne,  General 129,  154,  299 

Burnett,  Joseph 409 

Burnett,  William 128 

Burns  -. 451 

Burns,  Robert  286,  327 

Burr,  Aaron 288,  295 

Butler    51 

Byron,  Lord 350 

Cabot,    Elizabeth    358 

Cabot,  George  358 

Cadwallader,   John    36 

Cadwallader,  Thomas 64,  65,  66,  70,  80,  84,  210 

Caldwell,   Charles    214,  273,  274,  330,  331,  384 

Calhoun 370 

Calvin,  John    11 

Campbell,  Alexander 107 

Canappe 399 

Candolle  de 313 

Cane,  Maj  or 119 

Carey,  Mathew  165,  335,  390 

Carlisle    209 

Catesby    75 

Celsus    400 

Chalmers,  Lionel   41,  67,  69,  71,  72,  73,  75,  77 

Chancellor    298 

Chandler,   Benjamin    452 

Channing,  Edward  T 311 

Channing,  Walter    255, 313 

Chapman,    Nathaniel    329-338,  427,  444,  461 

Charles    1 12,  16,  22 

Charles    II 12,  22 

Chatham,  Lord  12 


492  INDEX. 

PAGE 

Chauncey,  Charles  27 

Chaussier    253 

Cheselden     64,  104 

Child,   Robert    27 

Choate,  Rufus  420 

Church,    Benjamin    107,  109,  117,  118,  119,  120,  133 

Church,   Fleming    119 

Cicero    145 

Civiale   247 

Clark,  Alonzo  470 

Clark,  John    27, 28 

Clarke,  Edwin  H 2>2,7,  446 

Clay,  Henry  395 

Cleghorn     178 

Cline    235,  287,  358 

Clinton,  De  Witt  295, 297 

Clossy,  Samuel  95,  96 

Cobb,   David    107, 273 

Cobbett,  William   .* 171,  172 

Cochran,  John    107,  128, 466 

Coffin    254 

Cogswell,  W.  H 439 

Colden,  Lieutenant-Governor  38,  41,  58,  59,  60,  61,  62,  63,  64,  70, 

76,  95,  loi,  292 

Coleridge,  S.  T 350 

Collinson,  Mr 62 

Colton,  G.  S , 404 

Columbus,   Christopher    15 

Combe,  Andrew   454 

Conway  I53,  I54,  I55,  I57 

Cooke,  John  Esten   265,  270,  273,  387 

Cooper,  J.  Fenimore  297,  299 

Cooper,    Sir   Astley    85,209,211,235,236,237,238,241,242,246, 

248,  252,  266,  287,  291,  345,  346,  358,  455 

Cooper,    William    252 

Corbet,  John   107 

Cornwallis,  Lord    128,  130 

Ccrrea  de  Serra,  Abbe   297,  312 

Corvisart     206 

Coster,  Magdalena  298 

Couper,  James    442 

Cowper    15 

Coxe,  John  Redman 292,  310,  448,  449 

Craik    466 

Crawford,  Mrs 224,  225 

Cromwell,   Oliver    12,  16,  31,  140,  142 

Crosby,  Dixi    307 

Cullen    73,  86,  147,  I49,  160,  161,  162,  175,  178,  276,  290 


INDEX.  493 

PAGE 

Cummings,  John    1 16,  198 

Currie    390 

Curtis,  Alexander 33 

Curtis,  Thomas  B 420 

Cutter,  Ammi  Ruhamah   128 

Cutter,  John 45 

Cuvier    253 

Dal  'Honde,  Lawrence  44,  46,  54 

Dalsell   345 

Dana,  R.  H 420 

Dana,  R.  H.  (Jr.)    409 

Davidge,  John  Beale 448 

Davis    80 

Davis,  Charles  A 423 

Davis,  Jefferson   423 

Davis,  N.  S 430,  43i,  432,  433,  434,  435,  439 

Davis,    Samuel    144 

Davy,    Humphry    399, 419 

De  Butts  315 

De  Camp,  Miss    288 

Delafield,  Edward   437,  455 

Denmon    45i 

Desault    216 

Descartes,  Rene   13, 26 

Desfontaines    ■- 253 

Deveze  213,  214 

Dewees,  W.  E ZZ^ 

Dewees,  William  P 335,  45i,  452,  464 

Dexter,   Aaron   116,  195,  199,  201,  254,  360 

Dickson,  S.  H 440,  465 

Dieffenbach  247 

Dieskau.  Baron  96 

Digby,  Sir  Kenelm   24 

Dioscorides  399 

Dixwell   254 

Doctor's  Mob 192,  284 

Dodonaeus    399 

Dorsey,  John  Syng  212,  217 

Douglass,    William    38,  43,  44,  45,  46,  47,  48.  49-  5°,  52,  55-  59, 

dl,  64,  67,  71,  179,  194 

Downer   1 16 

Drake,   Daniel    265,  272,  273,  298,  329,  ZZ^,  369-396,  427,  450 

Drake,  Isaac    ZT^-,  372 

Draper   239 

Drinker,  Edward   178 

Drowne.  Samuel  102 

Duane,  Mayor  James   I93 


494  INDEX. 

PAGE 

Dubois   253 

Dudley,  Ambrose  264 

Dudley,    Benjamin   W 212,217,223,230,231,240,262-275,329, 

369,  371,  7>7'2,  376,  380,  384,  389,  450 

Dudley,  Mr 119 

Dudley,  Wilkins   274 

Duncan,  Sir  William loi 

Dunglison,  Robley 462,  463,  464 

Dunlap,  Alexander   469 

Dunsmore,  William 107 

Dupuytren    206,  217,  253,  291 

Dwight,  Thomas 420 

Dwight,  Timothy  181 

Dyckman 458 

Earle,  Sir  J  ames 287 

Eberle,  John    449,  450,  451 

Eddy,  Mary  298 

Eden,  Mrs 288 

Edinburgh    86,  89,  92,  147 

Edwards,  Jonathan   180 

Eliot,  S.  A 420 

Elizabethtown    131 

Ellenborough,  Lord 288 

E!n"«r,  Jonathan 92 

Emerson,  R.  vValdo 328 

Emerson,  William  254 

Emlen,  Miss 214 

Emmet  298 

Endicott,  Governor   24,  26 

Ether    397-426 

Eustis 116 

Evans,  Dr 463 

Everett,  Alexander 311 

Ewings,  William 198 

Fairman,  Giles 27 

Faraday  399 

Farren,  Miss 288 

Fuller,  Samuel   23,  24,  26,  28,  29,  31,  32,  184,  237 

Fenner,  E.  D 439 

Findley,  J.  C 374,  378 

Finley,  Rev.  Doctor   142,  I43,  MS 

Fisk,  John    27 

Flint,    Austin    318, 47i 

Flint,  John  B 273 

Forgue,   Samuel    128 


INDEX. 


495 


PAGE 

Fort  Lee  131 

Foster,  Isaac  107,  128 

Fothergill  62,  88,  98,  loi,  138,  297,  302 

Fourcrois    253 

Fox,  Charles  James  loi,  144 

Fox,  George 34,  35,  36 

Francis,  John  W 338-342,  417,  440,  447,  458 

Franklin,  Benjamin  12,  41,  44,  52,  63,  70,  'j'j,  79,  83,  93, 

148,  164,  169,  281,  338 

Froebel    326 

Frost,  Eben  H 410,  41 1,  414 

Frothingham,  Samuel  420 

Fuller,    Samuel    23,  24,  26,  28,  29,  31,  ^2,  184,  237 

Gage,  William 27 

Galen    1 1,  13,  73,  449 

Gamgee,  Sampson  216,  266 

Gano 374 

Garden,  Alexander  41,  63,  68,  69,  71,  74,  75,  76 

Gardner  254 

Gates,  General 153,  154,  155,  157,  299 

George  I 55 

George  II 13,  140 

George  III 103 

Gerhard,  W.  W 336,  2,Z7,  3^2,  364 

Gibbs,  Wolcott  314 

Gibson,  William  244, 343-353 

Girard,  Stephen 213 

Girardin 399 

Glover,  John   27, 80 

Godman,  John  D 335,  461,  462 

Goforth,  William  ;i72,  ;i7^,  375,  380 

Goodale,  George  Lincoln  129 

Goodhue,  Josiah  300 

Gorham,  Deborah 467 

Gorham,  John  255,  313,  360 

Gould  416 

Grant,  General 308 

Gray,  Professor  Asa 62 

Green,  Horace  469 

Green,  Samuel  A 23,  194,  197 

Gregory  221,  236 

Griffitts,    Samuel   P 168,  182 

Griscom,  John  H 441 

Gross,  Samuel  D 203,  220,  229,  233,  237,  263,  273,  370,  371,  378, 

386,  387,  392,  394,  396,  446,  449,  470 

Guerin    247 

Guiteau,   Ephraim    107 


496  INDEX. 

PAGE 

Hahnemann    321 

Haighton 235 

Hall,  Captain  Basil 297 

Hall,  Jeremiah 107 

Hall,  Nathan  317 

Halleck    297 

Haller    104,  206,  276,  472 

Halley,  Edmund  59 

Hamilton,  Alexander   144,  288,  295,  296,  301,  372 

Hamilton,  Dr 80 

Hammersley,   William    238 

Hampden,  John 31 

Hancock,  Governor  196 

Harrison,  General  Benjamin  374,  384,  395 

Harrison,  Joseph   132,  386 

Hartshorne,  Joseph  330 

Harvey    13,  15,  20,  23,  26,  27,  237 

Hawse,  James  107 

Haxall,  R.  W 442 

Haj^den,    Greenville    G 409,  41 1 

Haydon,    Robert    345 

Hays,  Isaac   336,  440,  441,  444 

Hayward,    George     412,  415,  416,  420 

Helm,    Peter     213 

Henry,    Patrick    16,  156,  157 

Herodotus     398 

Hersey,   Abner    198 

Hersey,    Ezekiel     198 

Herz     289 

Hewson     315, 436 

Higginson,   J.    P 420 

Hillary    178 

Hippocrates     11,  145,  146,  I74,  294,  449 

Hoar,  Leonard   27, 80 

Hoa-tho    399 

Hoffman    13.  73.  290 

Hodge,  H.  L 336,  4Si,  459,  460,  464 

Hodges,   Richard   M 412,  414,  417 

Holland,  Henry   247 

Hollingsworth,  Sarah  Charlotte   350 

Holly    384 

Holmes,  Oliver  Wendell   27,  201,  319,  321,  328,  339,  353»  354, 

416,  42s,  445,  470 

Holten,   Samuel    107 

Holyoke,   Edward  Augustus    in,  195,  357,  358 

Homans,   John    116,  133, 420 

Home  209 

Homer   1 1 


INDEX. 


497 


PAGE 

Homer,   William   E 214,  336 

Hooper,   Robert    420 

Hope    86 

Hosack,  Alexander   283 

Hosack,   David    246,  277,  279,  283-298,  301,  339,  340,  342, 

369,  427,  447,  456,  458 

Hospital,  Bush  Hill    213, 214 

Hospital,  Massachusetts  General    256 

Hospital,  New  York  100,  loi 

Hospital,  Pennsylvania 83,  84 

Hospitals    81 

Howard  254 

Howe,  General  Sir  William  156 

Howe,  Lord  George  Augustus  41 

Hubbard,  Abigail  180 

Hubbard,  G.  G 453 

Hughes,  J 33 

Hugo,   Victor    350 

Humboldt,  von   419 

Humphreys    221, 223 

Humphreys,   Mr 292 

Hunnewell,  H.  H 420 

Hunt    374 

Hunter,  John   ....  89,  204,  205,  206,  208,  209,  215,  216,  217,  235,  237,  287 

Hunter,   William    86, 88,  194 

Hunter,  William  (Rhode  Island)   89 

Hunters     104,  142,  472 

Hutchinson,  James    166,  182 

Huxley,  Thomas  Henry   11,13,  3^2,  327,  339 

Inderwick,  Mr 341 

Inoculation    47,  48,  50,  52,  54 

Institution,    Perkinean 282 

Irving,   Washington    297 

Ives  315 

Jackson  345 

Jackson,    Charles   T 398,  404,  408,  409,  410,  411,  413,  416,  417, 

418,  419,  421,  423,  424 

Jackson,  Henry  358 

Jackson,  James  (Jr.)   206,  361,  362,  363,  365,  366,  367 

Jackson,  James  (Sr.)  254,255,256,277,307,311,313,353-368, 

390,  420 

Jackson,  Jonathan   356 

Jackson,   Samuel    139,  152,  153,  162,  175,  336,  440 

James    ( Seminary)    220 

James  1 12,  13,  15,  20,  23 

James  II 12 

32 


498  INDEX. 

PAGE 

James,  Thomas  C 227,  296,  333 

Jameson,  H.  G 386,  387 

Jamieson,  William   107 

Jarvis   251 

Jay,  John   35,  193,  296 

Jefferson,  Thomas  16,  174,  308,  372,  463 

Jeffrey,  Francis  236,  350 

Jenner,  William   228,  277,  410 

Johnson   190 

Johnson,  James 229 

Johnson,  General  William 41 

Jones,  David 107 

Jones,  Edward   36 

Jones,  John  95,  96,  97,  98,  loi,  102,  104,  106,  121,  232,  390 

Jones,  Margaret   29 

Jones,  Mary  Wynne   36 

Jones,  Walter   128 

Jordan,  Mr 129 

Jordan,  Mrs 288 

Journal  de  Medecine  Militaire  282 

Junot,  Andoche  (General)    346 

Jussieu  313 

Kent,  James  ( Chancellor)   297 

Kerfbyle,  Johannes   34 

Kieft,   William    31 

Kierstede,  Hans   32 

Kimball,  Gilman  469 

King's  College 95 

Kircher    14 

Kirkland    254 

Kissam,  Richard  S 242,  455 

Kissam,  Samuel    93, 283 

Knight,    Jonathan    307,  437,  440,  444 

Knight  of  Medj idichi    247 

Koch    411 

Kocher     209 

Kuhn,  Adam  92,  149,  160,  182,  208 

Laennec  206 

La   Montague    31,  32,  35,  36 

Laud,  Archbishop 31 

Lafayette,  General   132,  i55 

Lang.  Andrew  250 

La  Roche,  Rene  462 

Larrey,  Baron   246,  266,  399 

L'Aumonier    229 

Law,  Mr 288 


INDEX. 


499 


PAGE 

Lawrence,  Abbott 420 

Lawrence,  Amos 420 

Lawson,  Thomas   468 

Lay,  Benjamin    178 

Lazarettos     81 

Lecky  327 

Le  Dran    15 

Lee,  C.  A 434 

Lee,  Charles  (General )    154,  155,  157,  292 

Lee,  Light-Horse  Harry   16 

Lee,  Thomas   397,  420 

Lettsom,  Isaac 138,  164,  302 

Leuwenhoek  14 

Lincoln,  Abraham   308,  369,  395 

Lining,  John   41,  67,  70,  75,  77 

Linnaeus     14, 92 

Lister,  Lord  40,  204,  228,  230,  426 

Liston,    Robert    400, 415 

Livingston,  Brockholst 295 

Lizars,  Mr 228 

Lloyd,  James 98,  194,  195,  251 

Lloyd,  Thomas 36 

Locke,  John  13,  15,  27,  28 

Long,  Crawford  W 329,  398,  402,  403,  404,  410,  421 

Long,  George 338 

Longfellow,  H.  W 328 

Longworth    374 

L'Orange  33 

Loudon    41 

Louis    206,  320,  364,  365,  366 

Lovell,  James  S 467 

Lovell,   Joseph    467, 468 

Lowell,  John   254, 312 

Lowell,  J.  A 420 

Lowell,  J.  R 328 

Ludwick,  Christopher  178 

Lyell,  Charles   327 

Lyman,  Theodore 420 

Maitland,  Mr 53 

Mansfield,  Colonel  Jared  377 

Mansfield,  Edward  D 371 

Marcy,  E.  E 398,  405 

Marshall,  John  (Chief  Justice)   16,  156,  212,  217,  287,  297 

Mary,  Queen   12 

Mason,  Jonathan 254 

Mason,  William  P 311 

Massey,  Rev.  Mr 47 


500  INDEX. 

PAGE 

Mather,  Cotton  (Rev.)   29,  36,  41,  44,  45,  48,  49,  50,  51,  52, 

53,  54,  67,  194 

Mathews,  Andrew   27 

Mauran    424 

McCall,  John 429 

McClellan,  George  351,  462 

McClellan,  John  H.  B 462 

McClung,  ]\Iiss  219 

McDowell,  Ephraim    212,  218-231,  232,  235,  236,  240,  263,  268, 

274,  305,  329,  343,  369,  372 

McDowell,  James  225 

McDowell,  J.  N 386,  387 

McDowell,  Samuel 219,  220 

McDowell,  William  A 227 

McKenzie   89 

McLean,  John  256 

McNevin  342,  458 

McVicker,   Rev.   John    94 

Mease,  James 174 

Medical  and  Philosophical  Register "j"] 

Medical  School  of  New  York 92 

Medical  Society  of  New  York 94 

Medicine,  Transjdvania  Journal  of 270 

Megapolensis,  Samuel 33 

Meigs,  Charles  D 459,  460,  464 

Mercer,  Hugh  117 

Metcalf,  Theodore  409 

Michaux    297 

Middleton,  Peter  95,  97,  98,  99,  loi,  102,  149,  279,  284 

Mifflin,   General    154,  155 

Mill,  John   Stuart    ,180 

Miller,   Edward    185,  190,  273,  283 

Mills,  Charles  K 172,  173 

Minot  116 

Minot,  Jerusha   46 

Mitchell  and  Miller 277,  447 

Mitchell,  John  74,  76,  77,  169,  170 

Mitchell,  John  K 461 

Mitchell,  Samuel  L 185,  189,  238,  283,  292 

Mitchell,  S.  Weir 80,  339 

Mitchell,  Thomas  D 449,  450,  458 

Monmouth    116 

Monro    302 

Montagu,  Lady  Mary  Wortley 1 5,  47,  53, 

Montcalm    41 

Montpellier 206 

Moore  Graeme   84 

Moore,  Governor  Sir  Henry   loi 


INDEX. 


501 


PAGE 

Moore,  James 399 

Moore,  Sir  John 346 

Moore,  "  Tom"  350 

Moore's  Diary  of  American  Revolution  112 

Morgagni    86,  105,  206 

Morgan,  John  ...  41,  74,  80,  96,  99,  105,  106,  107,  115,  116,  120,  121,  122, 
123,  124,  125,  126,  127,  129,  133,  146,  149,  157,  159, 
162,  179,  197,  202,  208,  210, 223,  284,  301,  390,  466 

Morley,  Robert  27,  28 

Morris,  Caspar   447 

Morris,  Gouverneur 301,  372 

Morse,  Samuel  F.  B 408 

Morse,  Moses   108 

Morton,  Marcus  420 

Morton,  S.  G 465 

Morton,  W.  T.  G 83,  228,  398,  400,  402,  404,  405,  406,  407,  408, 

409,  410,  411,  412,  413,  414,  415,  416,  417, 
418,  419,  420,  421,  422,  423,  424,  425,  426 

Mott,  Henry 233,  287 

Mott,  Valentine    212,  232-248,  249,  250,  338,  342,  371,  405, 

417,  455,  458,  462 

Moultrie,  John 41,  68,  70,  98 

Moultrie,  James   444 

Muhlenburg,  Henry 312 

Munro   86,  221,  236 

Napoleon    267,  346,  350 

Nevins,  Laird  W 417 

Newark   131 

New  York  School 99 

New  York  University 100 

Nottingham    143 

Noyes  424 

Oglethorpe,  Governor  41 

Oliver,  James 27 

Osborne 45i 

Osier,  William 206,  364,  452,  453 

Overton  272 

Owen,  Griffith  41 

Packard,  F.  R 8,  43,  58,  63,  83,  115,  117,  129,  132,  189, 195 

Paget,  Sir  James 216,  248 

Paine,  Martyn 239,  435,  436,  437 

Paisley 147 

Parck,  Jan  du  33 

Park,  Roswell  146 

Parkman,  Willard  386,  387,  417 


502  INDEX. 

PAGE 

Parrott,  Miss 408 

Pasteur    40,  228,  426 

Pattison,  G.  S 239,  438 

Pearson   287 

Peaselee,   E.   R 224, 469 

Peekskill   134 

Pendleton,  Nathaniel 297 

Penn,   Thomas    88,  102 

Penn,  William 34,  35,  36,  58,  140 

Pennock    364 

Perkins,  Cyrus 304 

Perkins,  Elisha 280,  281,  282 

Perkins,  Richard   108 

Peter  Porcupine's  Gazette  172 

Physick,  Edmund 207 

Physick,   Philip   Syng   .  .  .   206-218,  221,  223,  227,  230,  232,  235,  237,  240, 
241,  269,  285,  310,  344,  348,  349,  350,  375,  447 

Pickering,  Colonel   iii 

Pilarini    49 

Piorry    364 

Pitt,  William 144,  288 

Plato II 

Plenciz 14 

Pliny    399 

Pocahontas     15 

Polk,  James  K 230 

Pomeroy,   Seth    452 

Pope,  Mrs 288 

Post,    Wright    238,  239,  242,  284,  455,  458 

Pott,  John    (Governor)    21 

Pott,   Percival   14, 97,  104 

Potts,  Jonathan    92,  128,  129 

Pratt,  John    27 

Prescott,    Colonel    1 10,  116 

Prescott,  W.  H 420 

Prestman,   Mr 213 

"  Pretender"    117 

Prince   Regent    288 

Princeton    89,  131,  147 

Pringle    I74,  178 

Progress  of  the  Century,  The   206 

Prout,    Robert    207 

Provincial    Congress    103,  107,  1 10, 

Putnam,  James  Jackson    356,  358,  367 

Pym,  John    31 

Pynchon,  Charles    108 

Quincy,  Josiah    254, 420 


INDEX.  503 

PAGE 

Raleigh,  Sir  Walter   20 

Ramsay,   David    40,  57,  73,  n?,  I43,  162,  166,  171,  390 

Rand,  Isaac   195 

Rawle,  Mr 296 

Ray,  Isaac    172, 470 

Redman,  John    84,  86,  87,  145,  146,  149,  292,  447 

Rembrandt 226 

Renwick,   William    286 

Revere,  Dr 239 

Revere,  Paul   109 

Rhees     462 

Ribes    253 

Rice,  Nathan  P 417 

Richardson,  Benjamin  W 165 

Richardson,  W.  H 265,  272,  273,  297,  384,  450 

Ricord    350 

Ridgley,   Frederick    264 

Rittenhouse    178 

Rivers,    Right  Hon.   Lord    282 

Rives,  L.  C 386,  387 

Robertson    287 

Roby    53,  54 

Rogers,  James  B 386,  387 

Rogers,   John    27 

Rogers,  J.  Kearney  455 

Rohrer     382 

Rontgen    410 

Ropes,   William    420 

Row^e,  George  119 

Royal  Society 74,  77,  87,  97 

Rumford,    Count    1 16,  313,  314 

Rush,  Benjamin   40,  60,  65,  66,  76,  Tj,  85,  92,  106,  116,  127-178, 

182,  189,  200,  202,  208,  214,  215,  221,  223, 

269,  274,  285,  290,  292,  293,  294,  297,  301, 

310,  331,  ZZ'^,  334,  340,  3SI,  369,  375,  390, 

447,  448,  470 

Rush,  James    142 

Rush,  John  140,  142 

Rush,  Mrs 142 

Rushlight    172 

Russell,  Walter    20,  21,  23,  37 

Rutherford   - 86 

Sabatier     253 

Sabine,   Captain    297 

Saltonstall,  Henry  27 

Saratoga   116,  129,  134 

Saunders,   William    359 


504  INDEX. 

PAGE 

Savage,  James  27 

Sawyer,   Ebenezer    108 

Scandella    189,  190 

Schult,  Gerrett   32 

Schujder,  Philip   (General)    123,  125 

Scollay,  Mary   315 

Scott,  Sir  Walter  236 

Scott,  Winfield   (General)    349, 467, 469 

Scull,  Mr 65 

Seabury,   Samuel    27 

Seaman,   Valentine    234 

Shattuck,  G.  C 420 

Shaw,  W.  S 254 

Shelby,  Sarah  223 

Shippen,  William  ( Sr.)    89 

Shippen,    William    (Jr.)....  41,80,87,89,90,93,98,106,107,116,121, 

124,  125,  126,  127,  128,  131,  146,  149, 

152,  157,  159,  168,  182,  194,  202,  208, 

210,  215,  232,  447,  466 

Short,  Dr 270 

Short,  Anna  Maria  274 

Short,  Major  Peyton   274 

Shotwell,  Elizabeth  371 

Siddons,  Mrs 288 

Silliman    298 

Simpson,  Sir  James  400 

Sims,  J.  Marion   404,  471 

Sisson,  Harriet  ^"77 

Slack,  Elijah   382 

Sloan,  Sir  Hans  55 

Smith,  Elihu  Hubbard    179-191,  214,  283,  286,  287,  363,  447 

Smith,  James    95)  97.  152 

Smith,  Jesse 382 

Smith,  John  15,  19,  20,  21,  37 

Smith,  John  Augustine   239 

Smith,  Nathan   201,  228,  240,  298-307,  iZZ,  342,  390,  459 

Smith,  Nathan   R 299 

Smith,   Reuben    180 

Smith,  Sir  J.  E 313 

Smith,  Sydney 236 

Smith,  William   132 

Smith,  William   Pitt   290 

Smyth,  A.  W 243 

Socrates     46 

Sommering     105 

Soult,  Nicolas  (Marshal)    346 

Spear,  Thomas  R.  ( Jr. )   408 

Spencer,  Herbert   327 


INDEX. 


505 


PAGE 

Staats    33 

Stanley    374 

Starr,  Comfort   27 

Stearns,  John 439 

Stephenson   96 

Steuben,    Baron    193 

Stevens,  Alexander  H , 242,  444,  455 

Stewart,  Dugald  332,  350 

Stewart,  F.  Campbell  439, 440 

Stiles,  John   373 

Stille,  Alfred 437,  439,  440,  444 

St.  Martin,  Alexis  452,  453,  454 

Stith     19 

Stockton,  Richard   153 

Stone    374 

Storer,  Malcolm  8 

Story,   Justice    297 

Stowe,  Mrs.  H.  B 180,  396 

Stringer,  Samuel   123,  124 

Stubbe    28 

Sturgis,  Russell    420 

Sturgis,  William 420 

Sully 140 

Sultan,  The   247 

Sutton,  W.  L 272 

Swift,  Dean   71 

Sydenham,   Thomas    13,  15,  27,  28,  138,  145,  174,  178,  294,  472 

Symmes     374 

Taylor,  John   108 

Tennent,  Gilbert  (Rev.)  150 

Tennent,  John  V.  B 95,  97,  98 

Tenney,  A.  G 411 

Thacher,  James    45,  55,  65,  68,  93,  iii,  114,  116,  118,  120,  129, 

133,  194,  280,  390 

Thacher,  Thomas   (Rev.)    29 

Thackeray,  W.  M 342 

Theodoric   399 

Thomas,  T.   Gaillard   446, 45i,  460 

Thompson  53,  54 

Thompson,  Alexander 430 

Thorndike,  Augustus    420 

Thornton,  Matthew 116 

Ticknor,  George  311 

Tilton,    James 02,  129,  130,  466 

Timonius 48,  49 

Toner,   J.   M 27,  129 

Townsend,  Solomon  D 412 


5o6  INDEX. 

PAGE 

Treat,  Malachi 128,  184,  193 

Trenton   131 

Trevelyan,  G.  0 250 

Trotter 164 

Trowbridge,  John 314 

Tryon,  Governor 60 

Tucker,  L 434 

Tucker,  Robert  93,  283 

Tuckerman  254 

Tufts,  Cotton 195 

Tuke,  Hack   138 

Turner,  Philip 128 

Tyndall,  John 313,  339 

University  of  Pennsylvania 93 

University  of  the  State  of  Pennsylvania 93 

Upsala,  University  of  92 

Vaccination    48, 359 

Van  de  Bogaerdet,  Mynderts  31 

Vanevenger    33 

Van   Helmot    11 

Van    Swieten    68 

Vauquelin     253 

Velpeau     247,  350,  419 

Venables,    James    403 

Victoria,   Queen    261 

"  Vindication,"    Morgan's    125,  127 

Virchow,    Rudolph    204,  335,  339,  460 

Vogel     289 

Voltaire     86 

Wadsworth,   Jolin    25 

Wagstaffe     55 

Wainwood    119 

Wallace,  Captain    119 

Wallace,  Dr 374 

Walter,  Mr 53.  75 

Ward,  Mr.  Secretary   119 

Ware,  John    318 

Warner,    Catherine    285 

Warren,  Edward   in 

Warren,  John    106,  109,  no,  1 1 1,  i  u.  114,  116,  120,  129,  131, 

195,  197,  198,  199,  200,  201,  212,  232,  235,  240, 

249,  253,  254,  256,  286,  301,  309,  360,  466 

Warren,  John  Collins  ...   235,249-262,289,297,313,351,353,357,359, 

360,  361,  394,  395.  405.  41 1,  412,  413.  414, 
415,  416,  418,  420,  427,  445 


INDEX. 


507 


PAGE 

Warren,  J.  Collins,  F.R.C.S 249,  251 

Warren,  Jonathan  Mason  249,  260,  412,  470 

Warren,  Joseph    108,  109,  T51 

Warrington,  Harry   143 

Washington,  George  12,  16,  41,  iii,  113,  120,  122,  124,  126,  128, 

133,  134,  138,  140,  144,  153,  154,  155,  156, 
174,  288,  296,  330,  332,  466 

Waterhouse,  Benjamin    199,201,254,276,359,360,361,449 

Watson    88 

Watson,  John   417,  439,  440,  441,  455,  456 

Watson's  Annals    141 

Way,  Nicholas    92 

Webb,   General    41 

Webster,  Daniel  303,  304,  308,  370,  420 

Webster,  Noah   188 

Weems,  Mason  143 

Welch    116 

Wells,  Horace    398,  400,  404,  405,  406,  408,  411,  421 

Wendell,  Barrett    44 

Wentworth     31 

Wheelock,    President    301, 302 

Whipple    251 

Whitney,  William    108 

Whytt    86 

Whytte    63 

Wightman,   Joseph    409, 413 

Willard,  Simeon   (President)    199 

William   III 12 

Williams,  Dr 134 

Williams,  Stephen   218 

Williamsburg     130 

Wills,    Daniel    36 

Wilkinson     155 

Wilson     156 

Winslow,    Governor    26 

Winthrop,  John    ( Jr. )    26,  28 

Winthrop,  John   ( Sr.)    24 

Winthrop,  Thomas  Lindall  262 

Wiseman  15 

Wistar,    Caspar    182,  215,  310,  375,  447,  448,  464 

Witherspoon,   D.D 147 

Wolcott,   Oliver    116 

Wolfe,  Charles   346 

Wolfe,  General  41, 298 

Wood,  George  B 459 

Woodhouse    375 

Woods,  Ann    178 

Woodville     358 


5o8  INDEX. 

PAGE 

Woodward    49 

Worley    220 

Wotton,  Thomas   19,  20,  21 

Wynne,  Thomas  35,  36 

Yandell 263,  273,  275 

Yeatman    374 

Yellow  fever   "jy,  213,  214,  274 

Zachery,  Lloyd   84 

Zeigler   374 

Zimmermann   164 


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